CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Preston Memorial Hospital

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $92
Cash Discount Price: $57
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Preston Memorial Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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
Aetna	$44 - $422	N/A
Humana	$44 - $282	N/A
Medicare (plans)	$44 - $380	N/A
Uhc_Va	$44 - $282	N/A
Advantra	$44 - $282	N/A
UPMC	$46 - $296	N/A
Medicaid / KanCare	$47 - $320	N/A
Blue_Cross_Highmark_Aca	$53 - $341	N/A
Blue_Cross_Highmark_Pos	$59 - $379	N/A
Blue_Cross_Highmark_Ppo	$59 - $379	N/A
Blue_Cross_Highmark_Traditional	$65 - $416	N/A
UnitedHealthcare	$66 - $422	N/A
Cigna	$67 - $432	N/A
Geha	$69 - $446	N/A
Health	$71 - $455	N/A
4_Most	$71 - $455	N/A
Unicare	$103	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 $57.
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 Preston Memorial 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.