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
HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP [149058]
Gary, IN
See all hospitals reporting CPT 90647 →Price type
The Methodist Hospitals, Inc.’s median price of $0 is 100% below the median hospital's median price ($53), higher than 0% of the 1,506 hospitals reporting CPT 90647. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 22 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 hmo_and_ppo_contracted_plans facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna medicare advantage facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Ambetter ambetter healthplan facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Anthem indiana hmo medicaid facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Anthem individual on exchange facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Anthem medicare advantage facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Anthem pathway essentials facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Anthem traditonal,hmo,ppo contracted plans and individual off exchange facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Caresource caresource facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Caresource indiana hmo medicaid facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Humana indiana hmo medicaid facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Humana medicare advantage facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Medicare medicare facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 14 | UnitedHealthcare indiana hmo medicaid facility · fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 15 | UnitedHealthcare hmo_and_ppo_contracted_plans facility · fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 16 | UnitedHealthcare navigate and core payer facility · fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 17 | Cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $113 | $113 | $71 | 63% | — | $42 – $184 |
| 18 | Cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $122 | $122 | $77 | 63% | — | $45 – $199 |
| 19 | Aetna firsthealth facility · percent of total billed charges · outpatientfrom % of charges | $183 | $183 | $115 | 63% | — | $68 – $298 |
| 20 | Phcs ppo facility · percent of total billed charges · outpatientfrom % of charges | $199 | $199 | $126 | 63% | — | $74 – $325 |
| 21 | MultiPlan ppo facility · percent of total billed charges · outpatientfrom % of charges | $214 | $214 | $135 | 63% | — | $79 – $349 |
| 22 | Aetna coventry facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $137 | 63% | — | $80 – $354 |
Last updated: Aug 18, 2026
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