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DTaP And Polio Combination Vaccine

South 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 $138 · 10th–90th $66$1740%20%10th90th$138Professionalmedian $68 · 10th–90th $62$1100%20%10th90th$68$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
$138.04
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$66.07
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$52.48
Typical High
$61.66
BCBS
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$72.44
Typical High
$79.43
BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$81.28
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$74.13
Typical High
$89.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$51.29
Typical High
$63.10
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$74.13
Typical High
$83.18