Meningococcal ACWY vaccine injection

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Vaccine Meningococcal Serogroups a/C/Y/W-135 Quadrivalent (Mcv4/Menacwy) Im

Payers reporting CPT 90734

Payer pricing summary

Low

Average

$259

Median

$247

High

$678

Payer rate distribution

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#
1	Wellmark fee schedule · outpatient · +17 other terms	32	$167	$169	$22	13%	332–386	$157 – $330
2	Caresource fee schedule · outpatient · +17 other terms	48	$180	$131	$46	35%	21–30	$1 – $311
3	Bcbs Mt percent of total billed charges · outpatientfrom % of charges	1	$130	$130	$5	4%	4–40	$127 – $139
4	Blue Cross Blue Shield fee schedule · outpatient · +33 other terms	270	$226	$283	$190	67%	3–30	$0 – $2.0k
5	Anthem fee schedule · outpatient · +23 other terms	106	$197	$226	$129	57%	2–20	$36 – $980
6	Medicaid facility · fee schedule · outpatient · +16 other terms	19	$157	$132	$43	33%	1–10	$10 – $173
7	UnitedHealthcare fee schedule · outpatient · +30 other terms	518	$330	$320	$172	54%	—	$0 – $1.2k
8	Cigna fee schedule · outpatient · +25 other terms	293	$315	$472	$318	67%	—	$0 – $1.6k
9	Humana fee schedule · outpatient · +25 other terms	197	$174	$375	$656	175%	—	$1 – $8.3k
10	Aetna fee schedule · outpatient · +30 other terms	150	$192	$406	$656	162%	—	$0 – $8.4k
11	MultiPlan fee schedule · outpatient · +19 other terms	75	$447	$493	$355	72%	—	$0 – $2.5k
12	Medica fee schedule · outpatient · +17 other terms	59	$167	$276	$139	50%	—	$0 – $602
13	Molina fee schedule · outpatient · +27 other terms	49	$157	$171	$79	46%	—	$1 – $428
14	Amerihealth Caritas facility · fee schedule · outpatient · +16 other terms	48	$16	$61	$59	98%	—	$10 – $266
15	Highmark facility · fee schedule · outpatient · +19 other terms	46	$93	$391	$374	96%	—	$11 – $1.5k
16	Tricare facility · fee schedule · outpatient · +18 other terms	37	$128	$166	$216	130%	—	$0 – $828
17	Regence facility · fee schedule · both · +15 other terms	30	$167	$218	$105	48%	—	$44 – $541
18	Premera facility · fee schedule · both · +12 other terms	28	$167	$220	$103	47%	—	$86 – $541
19	Carefirst facility · fee schedule · both · +12 other terms	27	$167	$221	$100	45%	—	$156 – $541
20	Excellus facility · fee schedule · both · +15 other terms	27	$167	$213	$94	44%	—	$156 – $541
21	First Health fee schedule · outpatient · +19 other terms	27	$400	$460	$381	83%	—	$0 – $2.1k
22	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$441	$391	$69	18%	—	$266 – $498
23	Bcbs Tx fee schedule · outpatient · +4 other terms	23	$376	$357	$90	25%	—	$104 – $579
24	Kaiser fee schedule · outpatient · +22 other terms	23	$331	$327	$272	83%	—	$26 – $1.8k
25	Bcbs La fee schedule · outpatient · +2 other terms	20	$179	$178	$6	4%	—	$153 – $190

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