CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Cody Regional Health

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90715
  • Insurance Median: $122
  • Cash Discount Price: $114
  • vs. Medicare Baseline: N/A Medicare
The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Cody Regional Health is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 707 Sheridan Avenue, Cody, WY.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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
Tricare $61 - $62 N/A
Cigna $105 - $107 N/A
Christian Hlthcare - All Plans $106 - $108 N/A
Blue Cross Blue Shield $114 - $129 N/A
First Choice Health - All Plans $119 - $122 N/A
Medica Comm - All Other Plans $119 - $122 N/A
Mountain Health - All Plans $119 - $122 N/A
Pacific Source - All Plans $119 - $122 N/A
Rocky Mtn Admin - All Plans $119 - $122 N/A
Interwest Health PPO - All Plans $121 - $125 N/A
First Health Ntwrk-All Plans $123 - $126 N/A
Humana $123 - $126 N/A
UnitedHealthcare $123 - $126 N/A
Three Rivers - All Plans $125 - $129 N/A

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 Sheridan Avenue, Cody, WY 82414
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals