Pneumococcal 20-valent conjugate vaccine, prefilled syringe at BSA Hospital

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

PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE

Amarillo, TX

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How this price compares nationally

BSA Hospital’s median price of $1.4k is 216% above the median hospital's median price ($435), higher than 96% 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 BSA Hospital

Negotiated rates from the hospital’s own file: 14 payers, 41 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 bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges	$274	$274	—	—	—	$274 – $274
2	Blue Cross Blue Shield bcbs tx medicaid chip [116506] facility · percent of total billed charges · bothfrom % of charges	$274	$274	—	—	—	$274 – $274
3	Blue Cross Blue Shield blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
4	Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
5	Cigna cigna medicare supplement [126012] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
6	Humana humana choicecare [214003] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
7	Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
8	Humana humana medicare supplement [214002] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
9	Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
10	Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
11	Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
12	Medicare rehab medicare [163504] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
13	Molina molina medicare advantage [167500] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
14	Ucare ucare medicare [283001] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
15	UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges	$468	$468	—	—	—	$468 – $468
16	UnitedHealthcare care improvement plus uhc [206002] facility · percent of total billed charges · bothfrom % of charges	$760	$760	—	—	—	$760 – $760
17	Aetna aetna nnj prime hmo [102003] facility · percent of total billed charges · bothfrom % of charges	$776	$776	—	—	—	$776 – $776
18	Aetna aetna supplement [101514] facility · percent of total billed charges · bothfrom % of charges	$776	$776	—	—	—	$776 – $776
19	UnitedHealthcare united healthcare texas exchange plan [206034] facility · percent of total billed charges · bothfrom % of charges	$936	$936	—	—	—	$936 – $936
20	Aetna aetna better health [351001] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
21	Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
22	Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
23	Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
24	Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
25	UnitedHealthcare uhc comm mcaid health pla [225001] facility · percent of total billed charges · bothfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k

Page 1 of 2 · 41 rates

Last updated: Feb 12, 2026

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See Pneumococcal 20-valent conjugate vaccine, prefilled syringe pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.