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
DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG (UIR)
Monroe, LA
See all hospitals reporting CPT 90697 →Price type
Brfhh Monroe, Llc’s median price of $169 is 19% below the median hospital's median price ($207), higher than 35% of the 1,208 hospitals reporting CPT 90697. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 14 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 | Bcbs La all payor fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna Better Health all payor other · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 3 | Amerihealth Caritas all payor other · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 4 | Humana all payor other · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 5 | UnitedHealthcare all payor other · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 6 | UnitedHealthcare all payor percent of total billed charges · outpatientfrom % of charges | $169 | $169 | $16 | 9% | — | $153 – $184 |
| 7 | Humana all payor fee schedule · outpatient | $184 | $184 | — | — | — | $184 – $184 |
| 8 | Cigna all payor other · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 9 | Cigna all payor other · inpatient | $263 | $263 | — | — | — | $263 – $263 |
| 10 | Aetna all payor other · inpatient | $342 | $342 | — | — | — | $342 – $342 |
| 11 | Aetna all payor other · outpatient | $342 | $342 | — | — | — | $342 – $342 |
| 12 | First Health all payor other · inpatient | $342 | $342 | — | — | — | $342 – $342 |
| 13 | First Health all payor other · outpatient | $342 | $342 | — | — | — | $342 – $342 |
| 14 | MultiPlan all payor other · outpatient | $369 | $369 | — | — | — | $369 – $369 |
Last updated: Apr 1, 2026
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