CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Graham Regional Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90715
  • Insurance Median: $122
  • Cash Discount Price: $241
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Graham Regional Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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
Amerigroup $23 - $122 N/A
Choicecare Network $23 - $122 N/A
Superior Healthplan $23 - $122 N/A
Wellpoint $30 - $165 N/A
Aetna $49 - $265 N/A
Cigna $49 - $265 N/A
Blue Cross Blue Shield $51 - $305 N/A
Three Rivers Provider Network $64 - $346 N/A
Health Advantage Network $68 - $366 N/A
Healthsmart Preferred Care $68 - $366 N/A
Curative $2,442 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Montgomery Road, Graham, TX 76450
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals