CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Methodist Rehabilitation Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $132
Cash Discount Price: $142
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Methodist Rehabilitation Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3020 West Wheatland Road, Dallas, TX.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

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 (%)

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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
Humana	$99 - $151	N/A
Group and Pension Administrators (Under Multiplan) (Primary)	$102 - $116	N/A
Multiplan (Pchs)	$102 - $116	N/A
Multiplan	$111 - $127	N/A
Aetna	$132 - $151	N/A
Ambetter / Centene	$132 - $151	N/A
Amerigroup	$132 - $151	N/A
Blue Cross Blue Shield	$132 - $151	N/A
Cigna	$132 - $151	N/A
Friday Health Commercial (PPO & EPO)	$132 - $151	N/A
Healthcare Highways	$132 - $151	N/A
Healthscope	$132 - $151	N/A
Medicare (plans)	$132 - $151	N/A
Molina Exchange	$132 - $151	N/A
Oscar Healthcare	$132 - $151	N/A
Scott & White Health Plan	$132 - $151	N/A
Southwestern Health Resources (Paid Under United Hc)	$132 - $151	N/A
Superior	$132 - $151	N/A
Texas Plus (Universal American)(Includes Wellcare - Merged With Texan Plus Eff 1/1/19)	$132 - $151	N/A
UnitedHealthcare	$132 - $151	N/A
Wellmed	$132 - $151	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 $142.
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 Methodist Rehabilitation Hospital 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.