CMS Price Transparency Data
Tdap vaccine (tetanus, diphtheria, pertussis)
Facility: Pali Momi Medical Center
Billing Code: 90715 (HCPCS)
The BaseRate · fair price low confidence
A fair price for this
$43
modeled fair price · typically $7–$92
modeled estimate · not a bill or quote
Fair price $43 Cash price $145 Hospital's list price $242
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
3 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Aetna✓ Kaiser Permanente Blue Cross Blue ShieldCignaHumana
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $4 | — |
| Aetnamajor | $206 | — |
| Kaiser Permanentemajor | $194 | — |
| + 9 smaller / regional plans | $4 - $194 |
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Pali Momi Medical Center
Compare: Tdap vaccine (tetanus, diphtheria, pertussis) at other HI hospitals
- Kohala Hospital · Kapaau $19
- Wilcox Memorial Hospital · Lihue $22
- Kona Community Hospital · Kealakekua $38
- Kapiolani Medical Center for Women & Children · Honolulu $38
- Kau Hospital · Pahala $39
- Samuel Mahelona Memorial Hospital · Kapaa $39
- North Hawaii Community Hospital, Inc · Kamuela $41
- Kuakini Medical Center · Honolulu $43
Insurance negotiated median for the same procedure, sorted lowest first.