CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Kentucky River Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90715
  • Insurance Median: $112
  • Cash Discount Price: $121
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Kentucky River Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 540 Jett Drive, Jackson, KY.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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
Blue Cross Blue Shield $36 - $77 N/A
Humana $95 N/A
UnitedHealthcare $112 N/A
Multiplan Primary Network-All Other Plans $121 N/A
Aetna $141 N/A
Multiplan Complementary Network $161 N/A
Cigna $161 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 540 Jett Drive, Jackson, KY 41339
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals