CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Stonesprings Hospital Center

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90700
Insurance Median: $184
Cash Discount Price: $417
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Stonesprings Hospital Center is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $417. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 24440 Stone Springs Boulevard, Dulles, VA.

Cash / Self-Pay

$417

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

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
Humana	$24	N/A
Cigna	$30 - $48	N/A
Johns Hopkins	$32	N/A
Aetna	$63	N/A
United	$98 - $188	N/A
Carefirst	$184	N/A
Greenvbrier Sporting Club	$250	N/A
Virginia Health Network	$296	N/A
Corvel	$300	N/A
Three Rivers Provider Network	$355	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 $417.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stonesprings Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90700.
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.