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
varicella-zoster PF 50 mcg/0.5 mL Susr 1 each KIT
Rapids, MN
See all hospitals reporting CPT 90750 →Price type
Allina Health Systems’s median price of $281 is 3% above the median hospital's median price ($274), higher than 52% of the 1,512 hospitals reporting CPT 90750. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 24 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $125 | $125 | $20 | 16% | — | $105 – $146 |
| 3 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | $23 | 16% | — | $116 – $161 |
| 4 | Medicaid medicaid ma (m) facility · fee schedule · outpatient | $183 | $183 | — | — | — | $183 – $183 |
| 5 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $205 | $205 | — | — | — | $205 – $205 |
| 6 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $219 | $219 | $36 | 16% | — | $183 – $255 |
| 7 | UnitedHealthcare uhc ubh pmap (m) facility · other · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 8 | Bcbs Mn bc premier (m u) facility · other · outpatient | $232 | $232 | — | — | — | $232 – $232 |
| 9 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $233 | $233 | $38 | 16% | — | $195 – $271 |
| 10 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $273 | $273 | — | — | — | $273 – $273 |
| 11 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $276 | $276 | $45 | 16% | — | $231 – $321 |
| 12 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $279 | $279 | — | — | — | $279 – $279 |
| 13 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $293 | $293 | — | — | — | $293 – $293 |
| 14 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $340 | $340 | $56 | 16% | — | $284 – $396 |
| 15 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $365 | $365 | $60 | 16% | — | $305 – $425 |
| 16 | Medica medica ubh (m) facility · percent of total billed charges · inpatientfrom % of charges | $436 | $436 | $71 | 16% | — | $364 – $507 |
| 17 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $446 | $446 | $73 | 16% | — | $373 – $519 |
| 18 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $466 | $466 | $76 | 16% | — | $390 – $542 |
| 19 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $466 | $466 | $76 | 16% | — | $390 – $542 |
| 20 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $490 | $490 | $80 | 16% | — | $410 – $570 |
| 21 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $498 | $498 | $81 | 16% | — | $416 – $579 |
| 22 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $523 | $523 | $85 | 16% | — | $437 – $608 |
| 23 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $523 | $523 | $85 | 16% | — | $437 – $608 |
| 24 | Medica medica ubh (m) facility · percent of total billed charges · outpatientfrom % of charges | $523 | $523 | $85 | 16% | — | $437 – $608 |
Last updated: Jun 17, 2026
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