CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Faulkton Area Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90715
  • Insurance Median: $44
  • Cash Discount Price: $149
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Faulkton Area Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1300 Oak Street Post Office Box 100, Faulkton, SD.
Cash / Self-Pay
$149

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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.

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 $38 N/A
Avera $40 N/A
Medica $44 N/A
Midland'S_Choice $51 N/A
United_Healthcare $54 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 Oak Street Post Office Box 100, Faulkton, SD 57438
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals