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DTaP And Polio Combination Vaccine

North Carolina 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 $72 · 10th–90th $43$1700%10%20%10th90th$72Professionalmedian $66 · 10th–90th $51$1550%20%10th90th$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$72.44
Typical High
$169.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$70.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$109.65
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$66.07
Typical High
$95.50
United
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$251.19
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$74.13
Typical High
$79.43
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09