CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: St Francis Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $168
Cash Discount Price: $167
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at St Francis Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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
Wexford	$26	N/A
Molina Healthcare	$28 - $51	N/A
Meridian Health Plan	$29	N/A
Humana	$49	N/A
Blue Cross Blue Shield	$49 - $53	N/A
Clear Spring Health of Illinois	$49	N/A
UnitedHealthcare	$51 - $232	N/A
Aetna	$51 - $163	N/A
Caterpillar, Inc.	$65	N/A
Amish Community	$65	N/A
Celtic Insurance Company	$118	N/A
Claim Doc	$122	N/A
Hopetrust	$134	N/A
Wellfirst	$149	N/A
First Health	$172	N/A
Current Health Solutions	$195	N/A
Multiplan/Phcs	$197	N/A
Consociate Group	$197	N/A
Healthlink	$198	N/A
Cigna	$207	N/A
Provider Network of America	$209	N/A
Healthcare Finest Network (Hfn)	$209	N/A
Interplan	$232	N/A
Live360	$232	N/A
Illinois Breast and Cervical Cancer Program	$232	N/A
Naphcare	$232	N/A
Health Alliance Medical Plans	$232	N/A
Healthscope	$232	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 $167.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90715.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Francis Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90715.
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.