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DTaP And Polio Combination Vaccine

New Jersey 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 $76 · 10th–90th $55$19,4980%10%20%10th90th$76Professionalmedian $66 · 10th–90th $59$1150%50%10th90th$66$20.0$100.0$500.0$2.0K$10.0K

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
$43.65
Median
$66.07
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$66.07
Typical High
$128.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$77.62
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$10,715.19
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$70.79
Typical High
$79.43