Pneumococcal 20-valent conjugate vaccine, prefilled syringe at The Methodist Hospitals, Inc.

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-VAL CONJ VACC 0.5 ML IM SUSY [176254]

Gary, IN

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How this price compares nationally

The Methodist Hospitals, Inc.’s median price of $383 is 12% below the median hospital's median price ($435), higher than 45% 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 The Methodist Hospitals, Inc.

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 medicare advantage facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
5	Anthem pathway essentials facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
6	Caresource caresource facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
7	Humana medicare advantage facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
8	Medicare medicare facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
9	Anthem indiana hmo medicaid facility · fee schedule · outpatient	$288	$288	—	—	—	$288 – $288
10	Caresource indiana hmo medicaid facility · fee schedule · outpatient	$288	$288	—	—	—	$288 – $288
11	Humana indiana hmo medicaid facility · fee schedule · outpatient	$288	$288	—	—	—	$288 – $288
12	UnitedHealthcare indiana hmo medicaid facility · fee schedule · outpatient	$288	$288	—	—	—	$288 – $288
13	UnitedHealthcare hmo_and_ppo_contracted_plans facility · fee schedule · outpatient	$383	$383	—	—	—	$383 – $383
14	UnitedHealthcare navigate and core payer facility · fee schedule · outpatient	$383	$383	—	—	—	$383 – $383
15	Anthem individual on exchange facility · fee schedule · outpatient	$391	$391	—	—	—	$391 – $391
16	Anthem traditonal,hmo,ppo contracted plans and individual off exchange facility · fee schedule · outpatient	$391	$391	—	—	—	$391 – $391
17	Cigna hmo facility · percent of total billed charges · outpatientfrom % of charges	$581	$563	$39	7%	—	$508 – $599
18	Cigna ppo facility · percent of total billed charges · outpatientfrom % of charges	$630	$611	$42	7%	—	$552 – $650
19	Aetna firsthealth facility · percent of total billed charges · outpatientfrom % of charges	$942	$913	$63	7%	—	$825 – $971
20	Phcs ppo facility · percent of total billed charges · outpatientfrom % of charges	$1.0k	$996	$69	7%	—	$900 – $1.1k
21	MultiPlan ppo facility · percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	$74	7%	—	$966 – $1.1k
22	Aetna coventry facility · percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	$75	7%	—	$980 – $1.2k

Last updated: Aug 18, 2026

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