Fee Schedule

Vaccine Fees

CPT
codes
Brand NameVaccine TypeVaccine
Fee
90678AbrysvoRespiratory Syncytial Virus (RSV)$356
90648ActHIBHaemophilus Influenzae Type B (HIB)$30
90715AdacelTdap$57
91318ComirnatyCOVID-19 monovalent – Pfizer (age 6m-4y)$72
91319ComirnatyCOVID-19 monovalent – Pfizer (age 5-11y)$95
91320ComirnatyCOVID-19 monovalent  – Pfizer (age 12y+)$147
90700DaptacelDTaP$41
90744Engerix-B/RecombivaxHepatitis B 10mcg (age 0-19y)$35
90682FlublokQuadrivalent Influenza$79
90686Fluzone/FluarixQuadrivalent Influenza$25
90662FluzoneHDHigh-Dose Quadrivalent Influenza$79
90651Gardasil-9Human papillomavirus (HPV)$347
90739Heplisav-BHepatitis B$170
90713IPOLPoliovirus, inactivated (IPV)$53
90619MenQuadfiMeningococcal ACWY$202
90707MMR IIMeasles, Mumps & Rubella$112
90698PentacelDTaP-IPV-HIB$134
90732Pneumovax-23Pneumococcal polyvalent$159
90677Prevnar20Pneumococcal conjugate$321
90696QuadracelDTaP, Polio$74
90680RotaTeqRotavirus$117
90750ShingrixZoster recombinant$240
90621TrumenbaMeningococcal B$230
90633VaqtaHepatitis A 25u (age 0-18y)$44
90632VaqtaHepatitis A 50u (age 19y+)$96
90716VarivaxVaricella$211
 ADMINISTRATION FEE per VACCINE$30
 COVID-19 ADMINISTRATION FEE$40

 

Health Services Fees

DeBug Shampoo$15
DeBug Oil$10
Lead Testing$25
Hgb Testing$20
TB Skin Test$20

 

*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.