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
DTAP IPV 0.5ML 4-6YR PDIM
Mt Shasta, CA
See all hospitals reporting CPT 90696 →Price type
Dignity Health’s median price of $347 is 240% above the median hospital's median price ($102), higher than 95% of the 1,548 hospitals reporting CPT 90696. 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, 25 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 | Anthem medicaid|all plans fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 2 | Aetna medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 3 | Anthem medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 4 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 5 | Humana medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 6 | Kaiser medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 7 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $104 | $104 | $8 | 8% | — | $96 – $111 |
| 8 | Anthem commercial|exchange fee schedule · outpatient | $276 | $276 | $21 | 8% | — | $255 – $297 |
| 9 | Anthem commercial|all other plans fee schedule · outpatient | $341 | $341 | $26 | 8% | — | $315 – $367 |
| 10 | Cigna commercial|all other plans fee schedule · inpatient | $354 | $354 | $27 | 8% | — | $327 – $380 |
| 11 | Cigna commercial|all other plans fee schedule · outpatient | $354 | $354 | $27 | 8% | — | $327 – $380 |
| 12 | Cigna commercial|ppo fee schedule · inpatient | $354 | $354 | $27 | 8% | — | $327 – $380 |
| 13 | Cigna commercial|ppo fee schedule · outpatient | $354 | $354 | $27 | 8% | — | $327 – $380 |
| 14 | UnitedHealthcare commercial|hmo fee schedule · inpatient | $371 | $371 | $28 | 8% | — | $343 – $399 |
| 15 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $371 | $371 | $28 | 8% | — | $343 – $399 |
| 16 | Aetna commercial|all other plans fee schedule · outpatient | $375 | $375 | $28 | 8% | — | $347 – $404 |
| 17 | Aetna commercial|hmo fee schedule · outpatient | $375 | $375 | $28 | 8% | — | $347 – $404 |
| 18 | Aetna commercial|ppo fee schedule · outpatient | $375 | $375 | $28 | 8% | — | $347 – $404 |
| 19 | Aetna commercial|all other plans fee schedule · inpatient | $380 | $380 | $29 | 8% | — | $351 – $408 |
| 20 | Aetna commercial|hmo fee schedule · inpatient | $380 | $380 | $29 | 8% | — | $351 – $408 |
| 21 | Aetna commercial|ppo fee schedule · inpatient | $380 | $380 | $29 | 8% | — | $351 – $408 |
| 22 | UnitedHealthcare commercial|all other plans fee schedule · inpatient | $380 | $380 | $29 | 8% | — | $351 – $408 |
| 23 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $380 | $380 | $29 | 8% | — | $351 – $408 |
| 24 | MultiPlan commercial|all plans fee schedule · inpatient | $423 | $423 | $32 | 8% | — | $391 – $455 |
| 25 | MultiPlan commercial|all plans fee schedule · outpatient | $423 | $423 | $32 | 8% | — | $391 – $455 |
Last updated: Feb 28, 2026
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