CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $169
Cash Discount Price: $190
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Ochsner Stennis Memorial Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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
Prime Health Services PPO -Workers Comp	$50	N/A
Cor Vel	$51	N/A
Humana	$112 - $165	N/A
UnitedHealthcare	$141 - $179	N/A
Cigna	$157 - $165	N/A
Medicare (plans)	$165 - $190	N/A
Ambetter / Centene	$167	N/A
Magnolia Health Plan – Wellcare By All Well of Mississippi	$167	N/A
Shared Health Mississippi	$174	N/A
Aetna	$179	N/A
Primewell Health Services Commercial Exchange Plan	$185	N/A
Primewell Health Services – Commercial	$185	N/A
Select Administrative Services Network	$193	N/A
Claritev D/B/A Multiplan/Phcs/American Life Care	$207 - $234	N/A
Zelis	$207	N/A
Prime Health Services PPO	$221	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 $190.
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 Ochsner Stennis 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.