CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Ira Davenport Memorial Hospital

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90700
Insurance Median: $43
Cash Discount Price: $16
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Ira Davenport Memorial Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$16

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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
Blue Cross Blue Shield	$23 - $201	N/A
Fidelis	$23 - $33	N/A
Fidelis Care - Exchange - All Plans	$29 - $36	N/A
Geisinger - All Plans	$31 - $39	N/A
Mvp Health Plan - All Plans	$33 - $41	N/A
Cigna	$33 - $41	N/A
Independent Health - All Plans	$34 - $43	N/A
Empire	$36	N/A
UPMC - All Plans	$37 - $46	N/A
Pomco Inc - All Plans	$38 - $48	N/A
UnitedHealthcare	$40 - $78	N/A
Aetna	$40 - $67	N/A
Emblem Health - All Plans	$47 - $58	N/A
Humana	$48 - $60	N/A
Emblem/Ghi	$49 - $69	N/A
Martins Point - All Plans	$53 - $66	N/A
Healthnow - All Plans	$175 - $219	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 $16.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ira Davenport Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90700.
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.