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Flu Shot, Preservative-Free, Four-Strain

North Dakota rates for HCPCS 90686

A seasonal influenza vaccine given as an injection into the muscle of the upper arm or thigh. It is made without a preservative and protects against four strains of flu virus expected to circulate that season. It is the standard version used for routine yearly flu protection in adults and older children.

Rates data updated October 2026.

How much does Flu Shot, Preservative-Free, Four-Strain cost?

$22.91

Typical negotiated rate. In North Dakota, October 2026.

Insurers have agreed to pay about $22.91 for this service. The price depends on where it is billed: about $24.55 from a physician practice, and about $19.95 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$24.55$22.39 to $24.55
FacilityA hospital or hospital-owned outpatient department$19.95$19.95 to $20.89

How much rates vary

Facilitymedian $20 · 10th to 90th $20 to $30Professionalmedian $25 · 10th to 90th $21 to $25
$20$50facility $20professional $25

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$42.66
BCBS North Dakota
Setting
Facility
Modifier
None
Typical Low
$17.38
Median
$22.39
Typical High
$56.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$28.18
Medica
Setting
Facility
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$33.88
Medica
Setting
Professional
Modifier
None
Typical Low
$22.39
Median
$24.55
Typical High
$24.55
United
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$24.55
Typical High
$24.55

Where North Dakota sits

The same service costs 1.9 times more in Alabama than in Rhode Island. 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 Dakota· 32nd of 51

$22.91

AL $38.90RI $19.95

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.