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DTaP And Polio Combination Vaccine

Maine 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 $200 · 10th–90th $81$2090%50%10th90th$200Professionalmedian $66 · 10th–90th $66$780%50%90th$66$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$69.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$75.86
Typical High
$85.11
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$69.18
Typical High
$102.33
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$67.61
Typical High
$114.82