CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Uva Health Culpeper Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $62
Cash Discount Price: $48
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Uva Health Culpeper Medical Center is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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
Aetna	$34 - $88	N/A
Champva [50002]	$38	N/A
Tricare	$38	N/A
UnitedHealthcare	$40 - $62	N/A
Geha [40009]	$44 - $62	N/A
Cigna	$47 - $122	N/A
Beacon Health Options [40012]	$50	N/A
Sentara [40021]	$52 - $78	N/A
Commercial Contracted Hb Only [40056]	$53	N/A
Commercial Generic [40000]	$53 - $70	N/A
Sentara Behavioral Health [40052]	$53 - $78	N/A
Multiplan Generic [40035]	$54 - $85	N/A
Vhn Generic [40040]	$54 - $85	N/A
Commercial Contracted Tpa [40055]	$60 - $70	N/A
Carefirst [30007]	$62	N/A
Kaiser Permenente [40014]	$64 - $90	N/A
Umwa [40037]	$70	N/A
Healthsmart [40013]	$75	N/A
First Health Generic [40033]	$82	N/A
Gateway Health Alliance [40034]	$85	N/A
Onenet Workers Comp Generic [60010]	$88	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 $48.
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 Uva Health Culpeper Medical Center 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.