Pneumococcal 20-valent conjugate vaccine, prefilled syringe at AMH Cath Labs LLC

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

PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML INTRAMUSC SYRG [151102]

Arlington, TX

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How this price compares nationally

AMH Cath Labs LLC’s median price of $511 is 18% above the median hospital's median price ($435), higher than 60% of the 2,154 hospitals reporting CPT 90677. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 90677 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 9 payers, 33 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	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$84	$84	—	—	—	$84 – $84
2	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$84	$84	—	—	—	$84 – $84
3	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$88	$88	—	—	—	$88 – $88
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$90	$90	—	—	—	$90 – $90
5	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$92	$92	—	—	—	$92 – $92
6	Blue Cross Blue Shield medicare advantage case rate · outpatient	$313	$313	—	—	—	$313 – $313
7	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$325	$325	—	—	—	$325 – $325
8	Humana medicare advantage case rate · outpatient	$325	$325	—	—	—	$325 – $325
9	Humana medicare advantage ppo case rate · outpatient	$325	$325	—	—	—	$325 – $325
10	Molina medicare advantage case rate · outpatient	$329	$329	—	—	—	$329 – $329
11	WellCare medicare advantage hmo case rate · outpatient	$329	$329	—	—	—	$329 – $329
12	WellCare medicare advantage mmp case rate · outpatient	$344	$344	—	—	—	$344 – $344
13	UnitedHealthcare medicare advantage ppo case rate · outpatient	$347	$347	—	—	—	$347 – $347
14	UnitedHealthcare medicare advantage hmo case rate · outpatient	$354	$354	—	—	—	$354 – $354
15	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$386	$386	—	—	—	$386 – $386
16	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$433	$433	—	—	—	$433 – $433
17	Blue Cross Blue Shield hmo fee schedule · outpatient	$508	$508	—	—	—	$508 – $508
18	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$514	$514	—	—	—	$514 – $514
19	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$519	$519	—	—	—	$519 – $519
20	Blue Cross Blue Shield exchange fee schedule · outpatient	$521	$521	—	—	—	$521 – $521
21	Blue Cross Blue Shield ppo fee schedule · outpatient	$564	$564	—	—	—	$564 – $564
22	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$653	$653	—	—	—	$653 – $653
23	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$654	$654	—	—	—	$654 – $654
24	Aetna asa percent of total billed charges · outpatientfrom % of charges	$658	$658	—	—	—	$658 – $658
25	Aetna coventry percent of total billed charges · outpatientfrom % of charges	$658	$658	—	—	—	$658 – $658

Page 1 of 2 · 33 rates

Last updated: Apr 21, 2026

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