CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Portneuf Medical Center

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90700
  • Insurance Median: $128
  • Cash Discount Price: $128
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Portneuf Medical Center is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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

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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
Healthcare Highways [2210] $87 N/A
Black Lung [6055] $87 N/A
Oncology Patient Assistance Programs [2295] $87 N/A
Moda Health [6100] $87 N/A
Lucent Health [6000] $87 N/A
Pending Ssi [1616] $87 N/A
Employee Benefit Management Services [2445] $87 - $128 N/A
Web Tpa [2115] $87 N/A
Pacific Source Health Plans [2850] $123 N/A
Medishare Christian Care [1645] $128 N/A
Multiplan [1680] $143 N/A
Worker's Comp [2125] $155 - $160 N/A
Transamerican Life [1990] $160 N/A
Enablecomp [1350] $160 N/A
Geha [1415] $192 N/A
UnitedHealthcare $192 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals