CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $149
Cash Discount Price: $149
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Ann & Robert H Lurie Childrens Hospital of Chicago is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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
Medicare (plans)	$8 - $2,656	N/A
Blue Cross Blue Shield	$16 - $233	N/A
Mercycare Health	$18 - $108	N/A
Cigna	$20 - $206	N/A
La Rabida Childrens Hospital	$24 - $145	N/A
Aetna	$24 - $228	N/A
Beacon Health Options	$24 - $145	N/A
UnitedHealthcare	$27 - $179	N/A
Independent Physicians at Mercy	$28 - $174	N/A
Centegra	$28 - $174	N/A
Methodist First Choice	$33 - $204	N/A
Health Plus	$33 - $204	N/A
Presence Health Partners	$33 - $204	N/A
St. Francis	$33 - $204	N/A
Imagine Health	$33 - $204	N/A
Northwest Community Healthcare	$33 - $204	N/A
Advanced Physicians Association IPA	$33 - $204	N/A
Ui Health	$33 - $204	N/A
West Suburban Health Providers	$33 - $204	N/A
Swedish Covenant Physician Partners	$36 - $218	N/A
Shriners Hospital	$36 - $218	N/A
American Psych Systems	$38 - $233	N/A
Macneal Health	$38 - $233	N/A
Magellan	$38 - $900	N/A
Health Alliance	$38 - $233	N/A
Healthlink Inc.	$39 - $240	N/A
St. Elizabeth	$40 - $247	N/A
Principal Healthcare	$40 - $247	N/A
Hfn Inc	$40 - $262	N/A
Cofinity	$40 - $247	N/A
Humana	$40 - $247	N/A
Sagamore Health Network	$42 - $256	N/A
Preferred Health Network	$42 - $256	N/A
First Health	$42 - $256	N/A
Healthstar	$42 - $256	N/A
Private Health Care System	$43 - $262	N/A
Swedish American	$43 - $262	N/A
Security Health Plan	$43 - $262	N/A
Beech Street	$43 - $262	N/A
Employer's Coalition on Health	$43 - $262	N/A
Benchmark Health	$43 - $262	N/A
Wellmark/Healthnetwork	$44 - $268	N/A
Integrated Health Plan	$45 - $276	N/A
Health Smart	$45 - $276	N/A
Wea Insurance Group	$45 - $276	N/A
National Provider Network	$45 - $276	N/A
Multiplan	$45 - $276	N/A
Unicare	$3,678 - $8,500	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 $149.
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 Ann & Robert H Lurie Childrens Hospital of Chicago 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.