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DTaP And Polio Combination Vaccine

Montana 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 $85 · 10th–90th $47$87,0960%20%40%10th90th$85Professionalmedian $79 · 10th–90th $63$1260%20%10th90th$79$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$125.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$46,773.51
Typical High
$91,201.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$77.62