CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: West Valley Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $113
Cash Discount Price: $148
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at West Valley Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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 (%)

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$33 - $147	N/A
Molina	$33	N/A
Select Health Idaho (Eirmc Only)	$45 - $49	N/A
Regence Blue Shield	$50	N/A
Corizon Health	$52 - $57	N/A
True Blue	$56 - $61	N/A
Cigna	$60	N/A
St Luke's Health Partners	$62	N/A
United	$65 - $93	N/A
Pacificsource Health	$84 - $93	N/A
Moda	$88 - $97	N/A
Aetna	$111 - $123	N/A
Multiplan	$113 - $124	N/A
Four Rivers Hospice	$113 - $124	N/A
Humana	$118 - $130	N/A
Geha PPO USA	$120 - $132	N/A
St Alphonsus Health	$127 - $140	N/A
Coventry First Health	$127 - $140	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 $148.
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 West Valley 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.