CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Pioneer Memorial Hospital - Cah

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90700
  • Insurance Median: $70
  • Cash Discount Price: $82
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Pioneer Memorial Hospital - Cah is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 315 N Washington Ave Post Office Box 368, Viborg, SD.
Cash / Self-Pay
$82

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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

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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
UnitedHealthcare $29 - $69 N/A
Aetna $65 N/A
Health Partners $68 N/A
United Medical Resources $69 N/A
Avera Health Plan $70 N/A
Medica $70 N/A
Dakotacare $70 N/A
Cigna $70 N/A
Sanford Health Plan $74 N/A
Blue Cross Blue Shield $79 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 N Washington Ave Post Office Box 368, Viborg, SD 57070
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals