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DTaP And Polio Combination Vaccine

Missouri 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 $93 · 10th–90th $66$2040%20%10th90th$93Professionalmedian $74 · 10th–90th $51$1100%20%10th90th$74$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
$93.33
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$72.44
Typical High
$112.20
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$109.65
Typical High
$169.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$117.49
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$79.43
Typical High
$275.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$204.17
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$74.13
Typical High
$79.43