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DTaP And Polio Combination Vaccine

Hawaii 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.

Professionalmedian $66 · 10th–90th $56$1000%50%10th90th$66$10.0$20.0$50.0$100.0$200.0

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
Professional
Modifier
Global
Typical Low
$56.23
Median
$66.07
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
HMSA
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$97.72
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$61.66
Typical High
$64.57