go back

California rates for HCPCS 90697

Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use

Facilitymedian $209 · 10th–90th $170–$3390%10%20%10th90th$209Professionalmedian $191 · 10th–90th $155–$3390%20%10th90th$191$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $162.18 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $186.21 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $208.93 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $398.11
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $223.87
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $371.54 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $323.59 / $398.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $218.78 / $398.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $467.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $199.53 / $407.38