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
54569-4055-00 - varicella virus vaccine - Powder
Bluffton, IN
See all hospitals reporting CPT 90716 →Price type
Bluffton Health System LLC’s median price of $193 is 24% below the median hospital's median price ($256), higher than 30% of the 1,851 hospitals reporting CPT 90716. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 17 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 | Tricare node tricare facility · fee schedule · outpatient | $97 | $97 | $97 | 100% | — | $0 – $193 |
| 2 | Aetna node aetna mcr adv facility · other · outpatient | $594 | $443 | $247 | 56% | — | $36 – $594 |
| 3 | Devoted node devoted health mcr adv facility · fee schedule · outpatient | $686 | $511 | $285 | 56% | — | $42 – $686 |
| 4 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $725 | $540 | $301 | 56% | — | $44 – $725 |
| 5 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $809 | $603 | $336 | 56% | — | $49 – $809 |
| 6 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $828 | $617 | $344 | 56% | — | $50 – $828 |
| 7 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $828 | $617 | $344 | 56% | — | $50 – $828 |
| 8 | Aetna aetna pssd jj facility · percent of total billed charges · inpatientfrom % of charges | $828 | $617 | $344 | 56% | — | $50 – $828 |
| 9 | Aetna aetna pssd jj facility · percent of total billed charges · outpatientfrom % of charges | $828 | $617 | $344 | 56% | — | $50 – $828 |
| 10 | Aetna aetna facility · percent of total billed charges · inpatientfrom % of charges | $1.0k | $760 | $424 | 56% | — | $62 – $1.0k |
| 11 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $1.0k | $760 | $424 | 56% | — | $62 – $1.0k |
| 12 | MultiPlan multiplan complementary facility · percent of total billed charges · inpatientfrom % of charges | $112 | $789 | $887 | 112% | — | $0 – $1.8k |
| 13 | MultiPlan multiplan complementary facility · percent of total billed charges · outpatientfrom % of charges | $112 | $789 | $887 | 112% | — | $0 – $1.8k |
| 14 | UnitedHealthcare uhc apa facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $798 | $445 | 56% | — | $65 – $1.1k |
| 15 | First Health first health non-exclusive facility · percent of total billed charges · inpatientfrom % of charges | $120 | $848 | $954 | 112% | — | $0 – $2.0k |
| 16 | First Health first health non-exclusive facility · percent of total billed charges · outpatientfrom % of charges | $120 | $848 | $954 | 112% | — | $0 – $2.0k |
| 17 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
Last updated: Apr 1, 2026
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