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.
Original text from hospital filings
PR Vaccine Meningococcal Serogroups a/C/Y/W-135 Quadrivalent (Mcv4/Menacwy) Im
Low
$5
Average
$778
Median
$173
High
$20k
Each hospital's average Devoted rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 10.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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41 hospital rates
iThe hospitals that file a Devoted rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $20k | $20k | — | — | — | $20k – $20k |
| 2 | Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient | 1 | $51 | $108 | $135 | 126% | — | $2 – $376 |
| 3 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 4 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $167 | $68 | 41% | — | $110 – $282 |
| 6 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $93 | $178 | $203 | 114% | — | $4 – $524 |
| 7 | Dupont Hospital LLC Wayne, IN facility · fee schedule · outpatient | 1 | $56 | $138 | $176 | 127% | — | $2 – $440 |
| 8 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $432 | $432 | $348 | 81% | — | $84 – $780 |
| 9 | IOM Health System LP Fort Wayne, IN facility · fee schedule · outpatient | 1 | $56 | $167 | $179 | 107% | — | $2 – $419 |
| 10 | Knox Hospital Company LLC Knox, IN facility · fee schedule · outpatient | 1 | $553 | $553 | — | — | — | $553 – $553 |
| 11 | La Porte Hospital Company LLC La Porte, IN facility · fee schedule · outpatient | 1 | $406 | $455 | $69 | 15% | — | $406 – $553 |
| 12 | Lancaster General Health Lancaster, PA facility · other · outpatient | 1 | $58 | $58 | $9 | 15% | — | $49 – $67 |
| 13 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · fee schedule · outpatient | 1 | $60 | $133 | $118 | 89% | — | $2 – $275 |
| 14 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $390 | $390 | $22 | 6% | — | $367 – $412 |
| 15 | MID-VALLEY HEALTHCARE INC Lebanon, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | $34 | 82% | — | $7 – $76 |
| 16 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $242 | $242 | — | — | — | $242 – $242 |
| 17 | Mercy Hospitals East Communities Washington, MO professional · percent of total billed charges · inpatientfrom % of charges | 1 | $14 | $65 | $73 | 111% | — | $14 – $168 |
| 18 | Mercy Hospitals East Communities Washington, MO professional · percent of total billed charges · outpatientfrom % of charges | 1 | $14 | $65 | $73 | 111% | — | $14 – $168 |
| 19 | Missouri Baptist Sullivan Hospital Sullivan, MO percent of total billed charges · bothfrom % of charges | 1 | $107 | $107 | — | — | — | $107 – $107 |
| 20 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 21 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $316 | $316 | — | — | — | $316 – $316 |
| 22 | NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR percent of total billed charges · outpatientfrom % of charges | 1 | $66 | $118 | $78 | 67% | — | $59 – $229 |
| 23 | SAMARITAN NORTH LINCOLN HOSPITAL Lincoln City, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $52 | $52 | $43 | 82% | — | $9 – $94 |
| 24 | SAMARITAN PACIFIC HEALTH SERVICES INC Newport, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | $39 | 82% | — | $8 – $87 |
| 25 | SID Peterson Memorial Hospital Kerrville, TX facility · percent of total billed charges · inpatientfrom % of charges | 1 | $255 | $255 | — | — | — | $255 – $255 |
← Payers reporting CPT 90734 · Snapshot 20261111T120946Z-9134e7f7