go back

DTaP And Polio Combination Vaccine

Pennsylvania 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 $66 · 10th–90th $54$2510%20%40%10th90th$66Professionalmedian $79 · 10th–90th $58$1700%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$66.07
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$79.43
Typical High
$169.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$251.19
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$125.89
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$117.49
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$60.26
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$79.43
Typical High
$97.72