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DTaP And Polio Combination Vaccine

New Hampshire 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 $87 · 10th–90th $66$2340%10%20%10th90th$87Professionalmedian $66 · 10th–90th $66$1200%50%90th$66$10.0$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
$66.07
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$74.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$134.90
Typical High
$234.42
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$66.07
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$154.88
Typical High
$199.53
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
$109.65
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$64.57
Typical High
$100.00