CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Hackensack Meridian Health Pascack Valley Medical

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $69
Cash Discount Price: $168
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Hackensack Meridian Health Pascack Valley Medical is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 250 Old Hook Road, Westwood, NJ.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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
Healthscope Benefits [2290]	$14	N/A
UnitedHealthcare	$14 - $157	N/A
Medicaid / KanCare	$24 - $84	N/A
Medicare (plans)	$30 - $76	N/A
Cigna	$43	N/A
Mvp Health Plan [2180]	$43	N/A
National Association of Letter Carriers [1695]	$43	N/A
Amerihealth [3520]	$61 - $67	N/A
Black Lung [6055]	$69	N/A
Commercial Generic [1285]	$69	N/A
Create Flex / Select [3580]	$69	N/A
Healthcare Highways [2210]	$69	N/A
Horizon [3625]	$69 - $157	N/A
Lucent Health [6000]	$69	N/A
Oncology Patient Assistance Programs [2295]	$69	N/A
Selecthealth [3740]	$69	N/A
Web Tpa [2115]	$69 - $72	N/A
Worker's Comp [2125]	$69 - $151	N/A
Wtc Healthcare Sme Karna [8005]	$69	N/A
1199 Seiu Benefit Fund [3505]	$72	N/A
Aetna	$72 - $82	N/A
Allied Benefit Systems Inc [1030]	$72	N/A
Meritain Health [1655]	$72	N/A
Nippon Life Ins Co [3695]	$72	N/A
Qualcare [3725]	$141 - $163	N/A
Magnacare Commercial [3650]	$151	N/A
Blue Cross Blue Shield	$157	N/A
Emblem Health [2430]	$163	N/A
Humana	$163	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 $168.
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 Hackensack Meridian Health Pascack Valley Medical 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.