CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Memorial Hermann Houston Physicians Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $9,823
Cash Discount Price: $5,423
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Memorial Hermann Houston Physicians Hospital is $9,823. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,423. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 333 N Texas Avenue, Suite 1000, Webster, TX.

Cash / Self-Pay

$5,423

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,823

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
Cigna	$40 - $22,109	N/A
Health Smart	$40	N/A
American National Insurance	$40	N/A
Tricare	$9,823	N/A
Kelsey-Seybold	$9,823	N/A
Aarp	$9,823	N/A
Medicare (plans)	$9,823	N/A
Coventry Health Care - McR	$9,823	N/A
Blue Cross Blue Shield	$9,823 - $10,806	N/A
Gpa	$9,823	N/A
Kelseycare Advantage	$9,823	N/A
Advantra Freedom McR Replace	$9,823	N/A
United Teachers Association	$9,823	N/A
Humana	$9,823 - $10,806	N/A
Devoted Health	$9,823	N/A
Aetna	$9,823 - $18,374	N/A
Advantra Freedom	$9,823	N/A
UnitedHealthcare	$9,823 - $10,806	N/A
Wellcare	$9,823	N/A
Texan Plus	$9,823	N/A
Health Spring	$9,823	N/A
Banker Life and Casualty	$9,823	N/A
Pffs	$9,823	N/A
Unicare-McR Replacement	$9,823	N/A
Champva	$10,806	N/A
Texas Health Spring	$10,806	N/A
Other	$10,806	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 $5,423.
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 Memorial Hermann Houston Physicians 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.