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DTaP And Polio Combination Vaccine

Utah 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 $56$710%20%40%10th90th$66Professionalmedian $66 · 10th–90th $65$1070%50%10th90th$66$50.0$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
$56.23
Median
$66.07
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$66.07
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Select Health
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$67.61
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$77.62
Typical High
$79.43