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DTaP And Polio Combination Vaccine

Georgia 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 $76 · 10th–90th $65$3630%20%10th90th$76Professionalmedian $66 · 10th–90th $62$1000%20%40%10th90th$66$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
$66.07
Median
$83.18
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$66.07
Typical High
$112.20
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$83.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$323.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$81.28
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$109.65
Typical High
$109.65
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$302.00
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$79.43
Typical High
$114.82