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DTaP And Polio Combination Vaccine

Indiana 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 $98 · 10th–90th $66$1480%20%10th90th$98Professionalmedian $66 · 10th–90th $56$1550%20%40%10th90th$66$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
Facility
Modifier
Global
Typical Low
$66.07
Median
$91.20
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$66.07
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$51.29
Typical High
$61.66
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$147.91
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$107.15
CareSource
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$117.49
CareSource
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$199.53
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$72.44
Typical High
$87.10