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DTaP And Polio Combination Vaccine

Illinois 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 $83 · 10th–90th $66$2090%10%20%10th90th$83Professionalmedian $76 · 10th–90th $60$1580%20%10th90th$76$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$64.57
Median
$74.13
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$77.62
Typical High
$158.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$223.87
Typical High
$851.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$144.54
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$44.67
Typical High
$147.91
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$34.67
Molina
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$53.70
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$251.19
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$79.43