go back

DTaP And Polio Combination Vaccine

Idaho 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 $62 · 10th–90th $51$810%20%10th90th$62Professionalmedian $76 · 10th–90th $66$1410%20%10th90th$76$20.0$50.0$100.0

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
$66.07
Median
$75.86
Typical High
$141.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$56.23
Typical High
$63.10
BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$66.07
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$81.28
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$66.07
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$70.79
Typical High
$134.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$77.62
Typical High
$79.43