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DTaP And Polio Combination Vaccine

South Dakota 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 $63 · 10th–90th $63$660%50%90th$63Professionalmedian $76 · 10th–90th $65$1580%20%10th90th$76$100.0

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
$64.57
Median
$77.62
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$75.86
Medica
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$181.97
Medica
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$70.79
Typical High
$70.79
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$70.79
Typical High
$79.43
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10