CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Rush Memorial Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $74
Cash Discount Price: $84
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Rush Memorial Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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
Health Net	$24 - $52	N/A
Humana	$25 - $164	N/A
Aetna	$25 - $164	N/A
My True Advantage - All Plans	$25 - $55	N/A
Caresource McR Adv	$25 - $55	N/A
UnitedHealthcare	$25 - $142	N/A
Today's Option McR Adv-All Plans	$26 - $57	N/A
Viant Beech St McR Adv	$26 - $57	N/A
Blue Cross Blue Shield	$26 - $130	N/A
Caresource Marketplace-All Other Plans	$40 - $88	N/A
Phcs-All Plans	$64 - $142	N/A
Cigna	$64 - $142	N/A
Coventry/First Health-All Plans	$72 - $160	N/A
Consumers Life Ins-All Plans	$72 - $160	N/A
Siho-All Plans	$74 - $164	N/A
Sagamore-All Plans	$74 - $164	N/A
Multiplan-All Plans	$74 - $166	N/A
Community Health Alliance-All Plans	$75 - $167	N/A
Encore Health Services-All Plans	$78 - $174	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 $84.
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 Rush Memorial Hospital 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.