CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Ivinson Memorial Hospital

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90700
Insurance Median: $214
Cash Discount Price: $227
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Ivinson Memorial Hospital is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 255 N 30Th, Laramie, WY.

Cash / Self-Pay

$227

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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
Wise Networks	$186 - $236	N/A
Blue Cross Blue Shield	$188 - $238	N/A
Cigna	$188 - $238	N/A
Great West Life	$188 - $238	N/A
Altius	$190 - $241	N/A
Coventry	$190 - $241	N/A
First Health	$190 - $241	N/A
Midlands Choice	$190 - $241	N/A
UnitedHealthcare	$190 - $241	N/A
Aetna	$192 - $243	N/A
Assurant	$192 - $243	N/A
Health Information Network	$192 - $243	N/A
Meritain	$192 - $243	N/A
Rci Insurance Group	$192 - $243	N/A
Starmark	$192 - $243	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 $227.
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 Ivinson Memorial Hospital 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.