Fee Schedule

Vaccine Fees

CPT
codes
Brand Name Vaccine Type Vaccine
Fee
90648 ActHIB Haemophilus Influenzae Type B (HIB) $29
90715 Adacel Tdap $56
90620 Bexero Meningococcal B $242
90700 Daptacel DTaP $38
90744 Engerix-B Hepatitis B 10mcg (age 0-19y) $32
90746 Engerix-B Hepatitis B 20mcg (age 20y+) $78
90682 Flublok Quadrivalent Influenza $74
90686 Fluzone Quadrivalent Influenza $23
90662 FluzoneHD High-Dose Quadrivalent Influenza $74
90651 Gardasil-9 Human papillomavirus (HPV) $323
90739 Heplisav-B Hepatitis B $161
90713 IPOL Poliovirus, inactivated (IPV) $47
90734 Menactra Meningococcal ACWY $170
90619 MenQuadfi Meningococcal ACWY $179
90707 MMR II Measles, Mumps & Rubella $106
90698 Pentacel DTaP-IPV-HIB $159
90732 Pneumovax-23 Pneumococcal polyvalent $158
90670 Prevnar13 Pneumococcal conjugate $276
90677 Prevnar20 Pneumococcal conjugate $305
90696 Quadracel DTaP, Polio $139
90680 RotaTeq Rotavirus $112
90750 Shingrix Zoster recombinant $206
90714 Tenivac Td $42
90621 Trumenba Meningococcal B $202
90636 Twinrix HAV-HBV $139
90633 Vaqta Hepatitis A 25u (age 0-18y) $41
90632 Vaqta Hepatitis A 50u (age 19y+) $92
90716 Varivax Varicella $192
  ADMINISTRATION FEE per VACCINE $30

 

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.