Cleveland Clinic Children's Hospital for Rehabilitation
Cleveland Clinic Children's Hospital for Rehabilitation in Cleveland, OH publishes cash prices for 100 common procedures listed here, from its own machine-readable price file updated Jun 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 73 of 100 procedures and below it for 16. By typical cash price it ranks #119 of 139 Ohio hospitals and #26 of 26 hospitals in the Cleveland, OH area, cheapest first. Select a procedure to compare it with other hospitals nearby.
2801 Martin Luther King Jr. Drive, Cleveland, OH 44104 Collected Sep 23, 2026 Source price file Check a bill from this hospital (216) 448-6400
Children's hospital Nonprofit hospital No emergency department CCN 363304 · CMS hospital register NPI 1033161948
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Cleveland Clinic Children's Hospital for Rehabilitation is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
Ohio's Hospital Care Assurance Program (HCAP): Ohio residents who are not on Medicaid and whose income is at or below 100% of the federal poverty level get basic, medically necessary hospital services free at hospitals in the program; physician bills are not included. Ask the hospital's billing office for an HCAP application. Other states' laws.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | 41% above | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABDOMEN 2 VIEWS | $477.10 | $734.00 | $207.58–$734.00 | — | 35% |
| Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 50% above | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW | $395.20 | $608.00 | $171.94–$608.00 | 77% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 46% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW | $395.20 | $608.00 | $171.94–$608.00 | 54% above | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | 45% above | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS | $395.20 | $608.00 | $171.94–$608.00 | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | 157% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $40.95 | $63.00 | $17.82–$63.00 | — | 35% |
| Blood glucose (sugar) test CPT 82947 *GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test CPT 82947 GLUC BLOOD QUANT ASSAY | $17.55 | $27.00 | $7.64–$27.00 | 26% below | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 *GLUCOSE QUANT | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUC BLOOD QUANT ASSAY | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | 25% below | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 I STAT BUN DETERMINATION (POINT OF CARE LAB) | $17.55 | $27.00 | $7.64–$27.00 | — | 35% |
| Creatinine blood test CPT 82565 *CREATININE BLOOD | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD (POINT OF CARE LAB) | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD ASSAY | $22.75 | $35.00 | $9.90–$35.00 | 8% below | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD (POINT OF CARE LAB) | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Creatinine blood test inpatient CPT 82565 *CREATININE BLOOD | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD ASSAY | $22.75 | $35.00 | $9.90–$35.00 | — | 35% |
| Hemoglobin blood test CPT 85018 *BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | 36% below | 35% |
| Hemoglobin blood test inpatient CPT 85018 *BLOOD COUNT HGB | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HGB (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY LACTIC ACID | $52.00 | $80.00 | $22.62–$80.00 | at median | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY LACTIC ACID | $52.00 | $80.00 | $22.62–$80.00 | — | 35% |
| Potassium blood test CPT 84132 *POTASSIUM SERUM | $21.45 | $33.00 | $9.33–$33.00 | 8% below | 35% |
| Potassium blood test CPT 84132 POTASSIUM | $21.45 | $33.00 | $9.33–$33.00 | 8% below | 35% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Potassium blood test inpatient CPT 84132 *POTASSIUM SERUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC N/C | $33.80 | $52.00 | $14.71–$52.00 | 41% below | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP ASSAY (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | 30% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC N/C | $33.80 | $52.00 | $14.71–$52.00 | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP ASSAY (POINT OF CARE LAB) | $74.10 | $114.00 | $32.24–$114.00 | — | 35% |
| Sodium blood test CPT 84295 *SODIUM BLOOD | $21.45 | $33.00 | $9.33–$33.00 | 21% below | 35% |
| Sodium blood test CPT 84295 SODIUM | $21.45 | $33.00 | $9.33–$33.00 | 21% below | 35% |
| Sodium blood test inpatient CPT 84295 *SODIUM BLOOD | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Sodium blood test inpatient CPT 84295 SODIUM | $21.45 | $33.00 | $9.33–$33.00 | — | 35% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB) | $18.20 | $28.00 | $7.92–$28.00 | at median | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB) | $18.20 | $28.00 | $7.92–$28.00 | — | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | $4.52–$16.00 | 56% below | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | $4.52–$16.00 | — | 35% |
| Urinalysis without microscope exam, manual CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | 4% below | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | $6.79–$24.00 | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $1,324.05 | $2,037.00 | $576.06–$2,037.00 | 139% above | 35% |
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $1,324.05 | $2,037.00 | $576.06–$2,037.00 | — | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $154.70 | $238.00 | $67.31–$238.00 | at median | 35% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $154.70 | $238.00 | $67.31–$238.00 | — | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $3,992.95 | $6,143.00 | $1,737.24–$6,143.00 | 146% above | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $3,992.95 | $6,143.00 | $1,737.24–$6,143.00 | — | 35% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $794.30 | $1,222.00 | $345.58–$1,222.00 | 164% above | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM | $794.30 | $1,222.00 | $345.58–$1,222.00 | — | 35% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC | $385.45 | $593.00 | $167.70–$593.00 | 33% above | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC | $385.45 | $593.00 | $167.70–$593.00 | — | 35% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $794.30 | $1,222.00 | $345.58–$1,222.00 | 109% above | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $794.30 | $1,222.00 | $345.58–$1,222.00 | — | 35% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $471.90 | $726.00 | $205.31–$726.00 | 60% above | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $471.90 | $726.00 | $205.31–$726.00 | — | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $882.70 | $1,358.00 | $384.04–$1,358.00 | 26% above | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $882.70 | $1,358.00 | $384.04–$1,358.00 | — | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $608.40 | $936.00 | $264.70–$936.00 | 247% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $1,885.65 | $2,901.00 | $820.40–$2,901.00 | 974% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $608.40 | $936.00 | $264.70–$936.00 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $1,885.65 | $2,901.00 | $820.40–$2,901.00 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R | $222.30 | $342.00 | $96.72–$342.00 | 20% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R | $222.30 | $342.00 | $96.72–$342.00 | — | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $313.30 | $482.00 | $136.31–$482.00 | 5% above | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $313.30 | $482.00 | $136.31–$482.00 | 1% above | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Group psychotherapy session CPT 90853 GROUP THERAPY | $180.70 | $278.00 | $78.62–$278.00 | 6% above | 35% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY | $180.70 | $278.00 | $78.62–$278.00 | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INIT 31-60MIN | $945.10 | $1,454.00 | $411.19–$1,454.00 | 126% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATE INIT 31-60MIN | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| IV push of a medicine, first drug CPT 96374 INJ IVPUSH INIT DRUG | $945.10 | $1,454.00 | $411.19–$1,454.00 | 268% above | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 INJ IVPUSH INIT DRUG | $945.10 | $1,454.00 | $411.19–$1,454.00 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM | $319.15 | $491.00 | $138.85–$491.00 | 126% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM | $319.15 | $491.00 | $138.85–$491.00 | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES | $1,396.85 | $2,149.00 | $607.74–$2,149.00 | 1% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES | $1,396.85 | $2,149.00 | $607.74–$2,149.00 | — | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112) | $132.60 | $204.00 | $57.69–$204.00 | 21% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEURMSCL THERAPY 15MIN | $132.60 | $204.00 | $89.47–$89.91 | 21% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112) | $132.60 | $204.00 | $57.69–$204.00 | 21% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA | $132.60 | $204.00 | $89.47–$89.91 | 21% above | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION OT (97112) | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 VV NEUROMUSCULAR EDUCATION PT (97112) | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURMSCL THERAPY 15MIN | $132.60 | $204.00 | $57.69–$204.00 | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN | $137.80 | $212.00 | $59.95–$212.00 | 113% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI | $137.80 | $212.00 | $59.95–$212.00 | 113% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION THERAPY, INITIAL 15 MIN | $137.80 | $212.00 | $59.95–$212.00 | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI | $137.80 | $212.00 | $59.95–$212.00 | — | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL - LOW | $438.10 | $674.00 | $190.61–$674.00 | 68% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 VV EVALUATION LOW COMPLEXITY (97165) | $438.10 | $674.00 | $190.61–$674.00 | 68% above | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 VV EVALUATION LOW COMPLEXITY (97165) | $438.10 | $674.00 | $190.61–$674.00 | — | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL - LOW | $438.10 | $674.00 | $190.61–$674.00 | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - HIGH | $393.25 | $605.00 | $171.09–$605.00 | 31% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163) | $393.25 | $605.00 | $171.09–$605.00 | 31% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - HIGH | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 VV EVALUATION HIGH COMPLEXITY (97163) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 VV EVALUATION LOW COMPLEXITY (97161) | $393.25 | $605.00 | $171.09–$605.00 | 51% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW | $393.25 | $605.00 | $171.09–$605.00 | 51% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 VV EVALUATION LOW COMPLEXITY (97161) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162) | $393.25 | $605.00 | $171.09–$605.00 | 42% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MOD | $393.25 | $605.00 | $171.09–$605.00 | 42% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 VV EVALUATION MODERATE COMPLEXITY (97162) | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MOD | $393.25 | $605.00 | $171.09–$605.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | $156.65 | $241.00 | $93.45–$93.91 | 41% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN | $156.65 | $241.00 | $93.45–$93.91 | 41% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | $156.65 | $241.00 | $68.15–$241.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN | $156.65 | $241.00 | $68.15–$241.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUT PROC/EXER 15 MIN | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | $92.52–$92.97 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | $72.96–$258.00 | 42% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUT PROC/EXER 15 MIN | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | $72.96–$258.00 | — | 35% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $313.30 | $482.00 | $136.31–$482.00 | 11% below | 35% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR | $607.10 | $934.00 | $264.14–$934.00 | 43% above | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR | $607.10 | $934.00 | $264.14–$934.00 | — | 35% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | 66% above | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | 17% above | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | at median | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | $136.31–$482.00 | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 DAY HOSPITAL FACILITY CHARGE | $156.00 | $240.00 | $68.25–$227.63 | 7% below | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 DAY HOSPITAL -HALF DAY | $156.00 | $240.00 | $67.87–$240.00 | 7% below | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 DAY HOSPITAL -HALF DAY | $156.00 | $240.00 | $67.87–$240.00 | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 DAY HOSPITAL FACILITY CHARGE | $156.00 | $240.00 | $67.87–$240.00 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN | $97.50 | $150.00 | $42.42–$150.00 | 16% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN | $97.50 | $150.00 | $42.42–$150.00 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $121.55 | $187.00 | $68.25–$160.68 | 11% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN | $121.55 | $187.00 | $52.88–$187.00 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN | $97.50 | $150.00 | $42.42–$150.00 | 3% below | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN | $97.50 | $150.00 | $42.42–$150.00 | — | 35% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND LANG COMPREH | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523) | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $651.30 | $1,002.00 | $283.37–$1,002.00 | 91% above | 35% |
| Speech and language evaluation inpatient CPT 92523 VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523) | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND LANG COMPREH | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $651.30 | $1,002.00 | $283.37–$1,002.00 | — | 35% |
| Speech therapy session, individual CPT 92507 VV SPEECH THERAPY (92507) | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY INDIV | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND | $307.45 | $473.00 | $133.76–$473.00 | 40% above | 35% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY INDIV | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Speech therapy session, individual inpatient CPT 92507 VV SPEECH THERAPY (92507) | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Speech therapy session, individual inpatient CPT 92507 TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND | $307.45 | $473.00 | $133.76–$473.00 | — | 35% |
| Spirometry (breathing test) CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $468.00 | $720.00 | $203.62–$720.00 | 51% above | 35% |
| Spirometry (breathing test) inpatient CPT 94010 SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $468.00 | $720.00 | $203.62–$720.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $178.10 | $274.00 | $93.88–$94.34 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 VV THERAPEUTIC ACTIVITIES (97530) | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERA FUNC ACTIVITIES 15M | $178.10 | $274.00 | $77.49–$274.00 | 46% above | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERA FUNC ACTIVITIES 15M | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 VV THERAPEUTIC ACTIVITIES (97530) | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $178.10 | $274.00 | $77.49–$274.00 | — | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | 300% above | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | 300% above | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | — | 35% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE | $1,324.79 | $2,038.14 | $576.39–$2,038.14 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | 20% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | 20% above | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | — | 35% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION | $447.80 | $688.92 | $194.83–$688.92 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | 123% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | 123% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | 126% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | 126% above | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $288.17 | $443.34 | $125.38–$443.34 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | — | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $291.15 | $447.93 | $126.67–$447.93 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | 105% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | 105% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | 111% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | 111% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE | $133.07 | $204.72 | $57.89–$204.72 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | — | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $136.99 | $210.75 | $59.60–$210.75 | — | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | 157% above | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | 157% above | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | — | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE | $502.91 | $773.70 | $218.80–$773.70 | — | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | 91% above | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | 91% above | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | — | 35% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT | $303.99 | $467.67 | $132.26–$467.67 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | 123% above | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $762.18 | $1,172.58 | $331.61–$1,172.58 | — | 35% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | at median | 35% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | at median | 35% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | — | 35% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVALENT | $184.99 | $284.60 | $80.48–$284.60 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | 6% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | 112% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | 112% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE NO PRESERV 0.25 ML | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE | $48.56 | $74.70 | $21.13–$74.70 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | — | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE | $97.11 | $149.40 | $42.25–$149.40 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | 196% above | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,536.64 | $2,364.06 | $668.56–$2,364.06 | — | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | 7% above | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | 7% above | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | — | 35% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE | $327.83 | $504.36 | $142.63–$504.36 | — | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | at median | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | 7% above | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | 7% above | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $194.18 | $298.74 | $84.48–$298.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | — | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $207.83 | $319.74 | $90.42–$319.74 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | 105% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | 106% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | 106% above | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $183.63 | $282.51 | $79.89–$282.51 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | — | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $185.00 | $284.61 | $80.49–$284.61 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | 7% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | 12% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | 12% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE | $167.23 | $257.28 | $72.76–$257.28 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | — | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $173.98 | $267.66 | $75.69–$267.66 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | 233% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | 233% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $728.91 | $1,121.40 | $317.13–$1,121.40 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | 122% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | 129% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | 129% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $133.46 | $205.32 | $58.06–$205.32 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $137.40 | $211.38 | $59.78–$211.38 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | 105% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | 105% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $143.79 | $221.22 | $62.56–$221.22 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | 1% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | 1% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $30.79 | $47.37 | $13.40–$47.37 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | 28% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | 28% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | 156% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | 156% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC PRSV FREE INC ANTIG | $132.15 | $203.30 | $57.49–$203.30 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $264.24 | $406.53 | $114.97–$406.53 | — | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | at median | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | at median | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | — | 35% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,380.97 | $2,124.57 | $600.83–$2,124.57 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | 7% above | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | 7% above | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION | $224.04 | $344.67 | $97.47–$344.67 | — | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | 31% above | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | 31% above | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | — | 35% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION | $669.63 | $1,030.20 | $291.34–$1,030.20 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | 30% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | 30% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $411.74 | $633.45 | $179.14–$633.45 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | 106% above | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | 106% above | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | — | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $825.36 | $1,269.78 | $359.09–$1,269.78 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | 113% above | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | 113% above | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,172.61 | $1,804.02 | $510.18–$1,804.02 | — | 35% |
| Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | 168% above | 35% |
| Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | 168% above | 35% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | — | 35% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $1,053.74 | $1,621.14 | $458.46–$1,621.14 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | at median | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | at median | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | 3% above | 35% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | 3% above | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE | $39.69 | $61.06 | $17.27–$61.06 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | — | 35% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 FLUMIST VACC NSPR 0.2ML | $40.89 | $62.90 | $17.79–$62.90 | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | 141% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | 141% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,056.18 | $1,624.89 | $459.52–$1,624.89 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | 118% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | 118% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,440.87 | $2,216.73 | $626.89–$2,216.73 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | 99% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | 99% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE | $547.93 | $842.97 | $238.39–$842.97 | — | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | 246% above | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | 246% above | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | — | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION | $220.25 | $338.85 | $95.83–$338.85 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | 34% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | 34% above | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | — | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE | $1,392.44 | $2,142.21 | $605.82–$2,142.21 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | 106% above | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | 106% above | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $2,784.87 | $4,284.42 | $1,211.63–$4,284.42 | — | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | 4% above | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | 4% above | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | — | 35% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $746.62 | $1,148.64 | $324.84–$1,148.64 | — | 35% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | 7% above | 35% |
| Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | 7% above | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,015.11 | $1,561.71 | $441.65–$1,561.71 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION | $1,016.98 | $1,564.59 | $442.47–$1,564.59 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | 27% below | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | 27% below | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | — | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATEQ VACCINE 2 ML ORAL SOLUTION | $99.45 | $153.00 | $43.27–$153.00 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | at median | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION | $504.29 | $775.83 | $219.40–$775.83 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | 2% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | 132% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $91.96 | $141.48 | $40.01–$141.48 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $207.85 | $319.77 | $90.43–$319.77 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | 103% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | 103% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | 107% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE | $224.13 | $344.82 | $97.52–$344.82 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $228.52 | $351.57 | $99.42–$351.57 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | 82% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | 82% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | 164% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | 164% above | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION | $521.57 | $802.41 | $226.92–$802.41 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $756.29 | $1,163.52 | $329.04–$1,163.52 | — | 35% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | 8% below | 35% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | 8% below | 35% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | — | 35% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE | $45.75 | $70.38 | $19.90–$70.38 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE PNEUMONIA | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE FLU | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SNGL | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ INJ-FLU VACCINE ONLY | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ INJ-HEP B VACC ONLY | $139.10 | $214.00 | $60.52–$214.00 | 242% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ INJ-HEP B VACC ONLY | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SNGL | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE FLU | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE PNEUMONIA | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ INJ-FLU VACCINE ONLY | $139.10 | $214.00 | $60.52–$214.00 | — | 35% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/childrens