CMS Price Transparency Data

DTaP vaccine (diphtheria, tetanus, pertussis)

Facility: Kootenai Health

Billing Code: 90700 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90700
Insurance Median: $35
Cash Discount Price: $40
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a DTaP vaccine (diphtheria, tetanus, pertussis) at Kootenai Health is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Molina Healthcare of Idaho	$11 - $25	N/A
Wellpoint	$17 - $18	N/A
Magellan	$17 - $18	N/A
Blue Cross Blue Shield	$20 - $60	N/A
Regence Blue Shield of Idaho	$23 - $37	N/A
Premera	$25 - $41	N/A
Group Health/Kaiser	$31 - $50	N/A
Aetna	$31 - $55	N/A
Mountain Health Co-Op	$32 - $51	N/A
Pacificsource	$34 - $54	N/A
Cigna	$34 - $55	N/A
First Choice Health (Ameriben)	$35 - $58	N/A
UnitedHealthcare	$35 - $60	N/A
Interwest Health	$35 - $56	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $40.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kootenai Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90700.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.