Fee Schedule

Vaccine Fees

CPT
codes
Brand NameVaccine TypeVaccine
Fee
90678AbrysvoRespiratory Syncytial Virus (RSV)$356
90648ActHIBHaemophilus Influenzae Type B (HIB)$30
90715AdacelTdap$59
90684CapvaxivePneumococcal conjucate (21 valent) (age 50+)$347
91318ComirnatyCOVID-19 monovalent – Pfizer (age 6m-4y)$72
91319ComirnatyCOVID-19 monovalent – Pfizer (age 5-11y)$95
91320ComirnatyCOVID-19 monovalent  – Pfizer (age 12y+)$170
90700DaptacelDTaP$41
90744Engerix-B/RecombivaxHepatitis B 10mcg (age 0-19y)$35
90673FlublokTrivalent Influenza$100
90656Fluzone/FluarixTrivalent Influenza$27
90662FluzoneHDHigh-Dose Trivalent Influenza$100
90651Gardasil-9Human papillomavirus (HPV)$349
90739Heplisav-BHepatitis B$179
90713IPOLPoliovirus, inactivated (IPV)$53
90619MenQuadfiMeningococcal ACWY$202
90707MMR IIMeasles, Mumps & Rubella$115
90698PentacelDTaP-IPV-HIB$155
90732Pneumovax-23Pneumococcal polyvalent$159
90677Prevnar20Pneumococcal conjugate$467
90696QuadracelDTaP, Polio$78
90680RotaTeqRotavirus$120
90750ShingrixZoster recombinant$240
90621TrumenbaMeningococcal B$250
90633VaqtaHepatitis A 25u (age 0-18y)$48
90632VaqtaHepatitis A 50u (age 19y+)$99
90716VarivaxVaricella$221
 ADMINISTRATION FEE per VACCINE$30
 COVID-19 ADMINISTRATION FEE$40

 

Health Services Fees

Lead testing$25
Hgb testing$20
TST$25

 

 

*All vaccine cost are subject to change depending on pharmaceutical prices. VFC or 317 fund vaccines are no cost for vaccines, but there will be a $20 Administration Fee per vaccine. Clients given vaccine paid by VFC or 317 funds will not be denied due to of inability to pay. All clients paying in full at the time of service for purchased vaccine are eligible for 20% discount of the total bill.