CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Cheshire Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $48
Cash Discount Price: $21
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Cheshire Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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 (%)

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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
Amerihealth Caritas Nh	$9 - $49	N/A
Wellsense Health Plan	$10 - $49	N/A
Granite State Health Plan	$12 - $49	N/A
Harvard Pilgrim Health Care of Ne	$16 - $34	N/A
Mass General Brigham Health Plan	$26 - $74	N/A
Maine Community Health Options	$33	N/A
Wellcare Health Plans	$36	N/A
Ambetter / Centene	$36	N/A
Mvp	$36 - $50	N/A
Martin's Point Generations Advantage	$36	N/A
Blue Cross Blue Shield	$36 - $130	N/A
UnitedHealthcare	$36 - $70	N/A
Cigna	$36 - $50	N/A
Martin's Point Health Care	$36	N/A
Aetna	$41 - $56	N/A
Tufts Health Plan	$42 - $48	N/A
First Health/Hcvm	$63	N/A
PHCS	$67	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 $21.
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 Cheshire Medical Center 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.