Combined DTaP, polio, Hib and hepatitis B vaccine at Samaritan 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

HC Vaccine Dtap-Ipv-Hib-Hepb Im

Troy, NY

See all hospitals reporting CPT 90697 →

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Pricing by billing methodology

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How this price compares nationally

Samaritan Hospital’s median price of $239 is 16% above the median hospital's median price ($207), higher than 56% of the 1,216 hospitals reporting CPT 90697. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 90697 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 15 payers, 27 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	Aetna aetna medicare advantage facility · percent of total billed charges · bothfrom % of charges	$120	$120	—	—	—	$120 – $120
2	Blue Cross Blue Shield blue shield of ne new york hmo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
3	Blue Cross Blue Shield blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
4	Carefirst blue shield of ne new york hmo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
5	Carefirst blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
6	Excellus blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
7	Highmark blue shield of ne new york ascend facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
8	Highmark blue shield of ne new york hmo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
9	Highmark blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
10	Premera blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
11	Regence blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
12	Wellmark blue shield of ne new york hmo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
13	Wellmark blue shield of ne new york ppo facility · fee schedule · both	$180	$180	—	—	—	$180 – $180
14	UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both	$252	$252	—	—	—	$252 – $252
15	Anthem empire bcbs blue access facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
16	Anthem empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
17	Blue Cross Blue Shield empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
18	UnitedHealthcare empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
19	WellCare wellcare ep 1&2 medicaid facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
20	Wellmark empire bcbs hmo epo ppo indemnity facility · percent of total billed charges · bothfrom % of charges	$359	$359	—	—	—	$359 – $359
21	First Health first health facility · percent of total billed charges · bothfrom % of charges	$383	$383	—	—	—	$383 – $383
22	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$407	$407	—	—	—	$407 – $407
23	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$431	$431	—	—	—	$431 – $431
24	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$431	$431	—	—	—	$431 – $431
25	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$431	$431	—	—	—	$431 – $431

Page 1 of 2 · 27 rates

Last updated: Mar 31, 2026

Compare to other hospitals

See Combined DTaP, polio, Hib and hepatitis B vaccine pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.