Fee Schedule

Vaccine Fees

CPT
codes
Brand NameVaccine TypeVaccine
Fee
90678AbrysvoRespiratory Syncytial Virus (RSV)$284
90648ActHIBHaemophilus Influenzae Type B (HIB)$30
90715AdacelTdap$58
90620BexeroMeningococcal B$254
91320ComirnatyCOVID-19 monovalent  – Pfizer (age 12y+)$135
90700DaptacelDTaP$41
90744Engerix-BHepatitis B 10mcg (age 0-19y)$34
90746Engerix-BHepatitis B 20mcg (age 20y+)$82
90682FlublokQuadrivalent Influenza$79
90686FluzoneQuadrivalent Influenza$25
90662FluzoneHDHigh-Dose Quadrivalent Influenza$79
90651Gardasil-9Human papillomavirus (HPV)$324
90739Heplisav-BHepatitis B$170
90713IPOLPoliovirus, inactivated (IPV)$50
90734MenactraMeningococcal ACWY$179
90619MenQuadfiMeningococcal ACWY$189
90707MMR IIMeasles, Mumps & Rubella$109
90698PentacelDTaP-IPV-HIB$134
90732Pneumovax-23Pneumococcal polyvalent$159
90670Prevnar13Pneumococcal conjugate$277
90677Prevnar20Pneumococcal conjugate$310
90696QuadracelDTaP, Polio$73
90680RotaTeqRotavirus$113
90750ShingrixZoster recombinant$222
90714TenivacTd$43
90621TrumenbaMeningococcal B$217
90636TwinrixHAV-HBV$147
90633VaqtaHepatitis A 25u (age 0-18y)$43
90632VaqtaHepatitis A 50u (age 19y+)$95
90716VarivaxVaricella$193
 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.