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Cost Estimator

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You may need to get a specific service code from your provider.
 
Code
Description
86580
tuberculin purified protein derivative 5 tuberculin units/0.1 mL Sol inoffice
90375
90375 Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use
90380
(VFC) CHARGE - no charge - Respiratory syncytial virus, monoclonal antibody. 0.5ml, IM
90380
90380 BEYFORTUS 50 MG/0.5 ML SYRINGE
90381
(VFC) CHARGE - no charge - Respiratory syncytial virus, monoclonal antibody. 1 ml, IM
90381
90381 Beyfortus RSV
90389
Tetanus immune globulin (TIg), human, for intramuscular use
90619
90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (
90619
No Charge - 90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxo
90632
90632 Hep A vaccine (Harvix), adult dosage, IM
90632
90632 Hepatitis A vaccine (HepA), adult dosage, IM
90632
Hepatitis A Adult Vaccine POC
90633
90633 Hepatitis A vaccine (HepA), pediatric/adolescent dosage, 2 dose schedule IM
90633
HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
90633
No Charge - 90633 Hepatitis A vaccine (2 dose)
90647
haemophilus b conjugate (PRP-OMP) vaccine (3 dose)
90647
Hemophilus inf B Vaccine, (HIB) PRP-OMP 3 dose, IM use
90647
No Charge - 90647 Hemophilus Influenza b vaccine (Hib) PRP-OMP conjugate (3 dose)
90647
No Charge - Hemophilus inf B Vaccine, (HIB) PRP-OMP 3 dose, IM use
90648
90648 Haemophilus influenzae Type B Conjugate Vaccine Charge
90648
Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for IM Use POC
90648
No Charge - 90648 Hemophilus Influenza b vaccine (Hib) PRP-T conjugate (4 dose)
90649
Gardisil
90649
human papillomavirus vaccine type 6,11,16,18 Sus inoffice
90649
NO CHARGE Gardisil VFC
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