CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Sky Ridge Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $481
Cash Discount Price: $1,355
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Sky Ridge Medical Center is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,355. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 10101 Ridgegate Pkwy, Lone Tree, CO.

Cash / Self-Pay

$1,355

Average discount available for prompt cash payment at this facility.

Insurance Median

$481

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Cigna	$44 - $867	N/A
United	$65 - $610	N/A
Rocky Mountain Health Plan	$119	N/A
Vail Health	$206	N/A
Kaiser	$271 - $481	N/A
Aetna	$406	N/A
Bright Health	$406	N/A
Western Plains Community Health	$881	N/A
Northcare	$948	N/A
Multiplan	$948 - $1,219	N/A
Physician Health Partners	$948	N/A
Blue Cross Blue Shield	$1,002	N/A
Pinnacol Workers Comp	$1,016	N/A
Medical Development International	$1,084	N/A
Triwest Health Alliance	$1,084	N/A
Prime Health	$1,219	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,355.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90715.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sky Ridge Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90715.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.