CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Connecticut Childrens Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $116
Cash Discount Price: $97
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Connecticut Childrens Medical Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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
UnitedHealthcare	$48 - $147	N/A
Golden Rule [100106]	$48 - $91	N/A
Oxford [100103]	$48 - $91	N/A
Harvard Pilgrim [1001134]	$48 - $132	N/A
Tufts Health Plan [100114]	$62 - $156	N/A
Mvp Health Plan [100144]	$62 - $156	N/A
Health Partners [110229]	$62 - $156	N/A
Great West Healthcare [100107]	$62 - $156	N/A
Cigna	$62 - $156	N/A
Blue Cross Blue Shield	$63 - $137	N/A
Wellpoint [100150]	$63 - $137	N/A
Unicare [100148]	$63 - $137	N/A
Emblem Health Commercial [1001108]	$67 - $147	N/A
Medicaid / KanCare	$67 - $147	N/A
Connecticare [100105]	$67 - $147	N/A
Aetna	$98 - $152	N/A
Multiplan [1001126]	$105 - $154	N/A
Government Employees Hospital Assoc [100115]	$109 - $152	N/A
Humana	$109 - $152	N/A
Meritain Health [100149]	$109 - $152	N/A
1199 National Benefit Fund [100134]	$109 - $152	N/A
Yale Health Plan [100162]	$109 - $152	N/A
Nippon Life Ins Co of America [100112]	$109 - $152	N/A
Cdphp/Comm [100199]	$122 - $154	N/A
Generic Multiplan [1001130]	$122 - $154	N/A
Ultrabenefits/Comm [100181]	$122 - $154	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 $97.
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 Connecticut Childrens 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.