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DTaP And Polio Combination Vaccine

Ohio 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 $98 · 10th–90th $65$2090%10%20%10th90th$98Professionalmedian $72 · 10th–90th $60$1480%20%40%10th90th$72$1.0$5.0$20.0$100.0$500.0

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
$64.57
Median
$95.50
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$147.91
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$61.66
Typical High
$66.07
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$138.04
Typical High
$416.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$75.86
Typical High
$125.89
CareSource
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$181.97
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$70.79
Typical High
$204.17
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$107.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$50.12
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$77.62
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$331.13
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$79.43