CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Southwest Health Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90715
  • Insurance Median: $40
  • Cash Discount Price: $39
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Southwest Health Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1400 East Side Rd, Platteville, WI.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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
Care Wisconsin $10 - $64 N/A
Blue Cross Blue Shield $10 - $99 N/A
UnitedHealthcare $11 - $81 N/A
Quartz $21 - $77 N/A
Cigna $26 - $74 N/A
Wps $26 - $74 N/A
Group Health Cooperative of Sc $27 - $86 N/A
Humana $31 - $89 N/A
Healthchoice $33 - $94 N/A
Dean Health Plan $34 - $43 N/A
Group Health South Central $34 - $99 N/A
Group Health Eau Claire $34 - $99 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 East Side Rd, Platteville, WI 53818
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals