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DTaP And Polio Combination Vaccine

Arizona rates for HCPCS 90696

A single injection protecting against four infections at once: diphtheria, tetanus, whooping cough, and polio. Combining them means one needle instead of separate injections for each. The charge covers the vaccine itself; giving the injection is charged separately.

Facilitymedian $170 · 10th–90th $42$3720%5%10th90th$170Professionalmedian $83 · 10th–90th $63$2090%20%10th90th$83$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$38.02
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$213.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$229.09
Typical High
$426.58
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$120.23
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$120.23
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$74.13
Typical High
$95.50
Medica
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$75.86
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$251.19
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$79.43