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NDC 58160-0884-52

Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage

Reported by 17 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$21

Average

$60

Median

$60

High

$183

Hospitals reporting this code

#HospitalLocation
1Ukiah Adventist HospitalUkiah, CA$56$116$105$147$23
2Adventist Health Medical Center TehachapiTehachapi, CA$34$76$78$229$39
3Adventist Health DelanoDelano, CA$19$62$59$115$13
4Simi Valley Hospital And Health Care ServicesValley, CA$28$61$60$115$16
5Adventist Health TulareTulare, CA$32$56$60$138$16
6Reedley Community HospitalReedley, CA$36$57$58$137$12
7San Joaquin Community HospitalBakersfield, CA$31$59$68$156$19
8Lodi Memorial Hospital Association IncLodi, CA$8$142$183$452$79
9Hanford Community HospitalHanford, CA$37$68$69$177$19
10White Memorial Medical CenterAngeles, CA$28$60$67$419$23
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