Hepatitis A vaccine, children and teens, two-dose series at Mercy Perry

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

HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE

Perryville, MO

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How this price compares nationally

Mercy Perry’s median price of $256 is 296% above the median hospital's median price ($65), higher than 98% of the 1,686 hospitals reporting CPT 90633. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 90633 at Mercy Perry

Negotiated rates from the hospital’s own file: 16 payers, 29 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	Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges	$62	$62	—	—	—	$62 – $62
2	Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges	$83	$83	—	—	—	$83 – $83
3	Medicaid hb pcmh mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$83	$83	—	—	—	$83 – $83
4	UnitedHealthcare hb pcmh uhc managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$83	$83	—	—	—	$83 – $83
5	Optum hb pcmh uhc all payer exchange facility · fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
6	UnitedHealthcare hb pcmh uhc all payer exchange facility · fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
7	UnitedHealthcare hb pcmh uhc core facility · fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
8	Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
9	Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
10	Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
11	Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
12	UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
13	WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
14	UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$128	$128	—	—	—	$128 – $128
15	Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$131	$131	—	—	—	$131 – $131
16	Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges	$131	$131	—	—	—	$131 – $131
17	Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges	$150	$150	—	—	—	$150 – $150
18	Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges	$173	$173	—	—	—	$173 – $173
19	Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges	$196	$196	—	—	—	$196 – $196
20	Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges	$196	$196	—	—	—	$196 – $196
21	Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$256	$256	—	—	—	$256 – $256
22	Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges	$256	$256	—	—	—	$256 – $256
23	Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$271	$271	—	—	—	$271 – $271
24	First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$271	$271	—	—	—	$271 – $271
25	Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges	$289	$289	—	—	—	$289 – $289

Page 1 of 2 · 29 rates

Last updated: Mar 12, 2026

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