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PCV20 Pneumococcal Vaccine Injection

North Carolina rates for HCPCS 90677 · Prevnar 20

This is an injection of a vaccine that protects against 20 different strains of the bacteria that cause pneumococcal disease, including pneumonia, meningitis, and bloodstream infections. It is given as a shot into a muscle, usually the upper arm, and is recommended for many adults and some children to lower the risk of serious pneumococcal illness. A single dose is typically enough to update protection to the newer, broader-coverage version of the vaccine.

Rates data updated July 2026.

How much does Prevnar 20 (pneumococcal 20-valent conjugate vaccine) cost?

$398

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $398 for this service. The price depends on where it is billed: about $380 from a physician practice, and about $525 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$380$295 to $550
FacilityA hospital or hospital-owned outpatient department$525$389 to $692

How much rates vary

Facilitymedian $525 · 10th to 90th $295 to $891Professionalmedian $380 · 10th to 90th $263 to $724
$10$20$50$100$200$500$1Kfacility $525professional $380

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$524.81
Typical High
$891.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$380.19
Typical High
$724.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$263.03
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$724.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$501.19
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$338.84
Typical High
$338.84
Medcost
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$371.54
Typical High
$457.09
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$512.86
Typical High
$575.44
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$354.81
Typical High
$363.08
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52

Where North Carolina sits

The same service costs 1.7 times more in Ohio than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 4th of 51

$398

OH $501HI $302

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.