90471

Administration of vaccine

Medicare pricing data for 81,604 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Administration of vaccine (HCPCS code 90471) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $18.63, but hospitals typically charge $47.83 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $18.63, your out-of-pocket cost would be approximately $3.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$18.63
Average Hospital Charge
$47.83
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$47.83
Medicare Allowed$18.63
Medicare Payment$12.65

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $12.65 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$22$493822,038+19.0%
Alaska$22$48174676+16.3%
New York$21$554,62217,605+15.2%
California$21$583,1328,859+13.3%
New Jersey$21$543,95920,268+12.7%
Hawaii$20$47113289+9.7%
Connecticut$20$499532,628+7.9%
Massachusetts$20$631,9646,848+7.6%
Maryland$20$482,91518,114+6.1%
Virginia$20$463,25817,459+6.0%
Colorado$19$462,3619,878+3.8%
Rhode Island$19$463121,167+3.0%
Illinois$19$492,5546,837+1.1%
North Dakota$19$7174280+0.7%
Washington$19$549222,405+0.7%
New Hampshire$19$554031,254-0.3%
Pennsylvania$18$436,14527,073-1.2%
Minnesota$18$431,0001,743-1.3%
Nevada$18$52282828-1.6%
Delaware$18$364092,751-1.7%
Puerto Rico$18$323884-1.7%
Georgia$18$562,95912,404-1.9%
Texas$18$467,42329,373-2.4%
Florida$18$475,16921,957-2.5%
Wisconsin$18$631,2382,585-3.5%
South Dakota$18$55141456-3.5%
Oregon$18$595221,349-4.0%
Michigan$18$431,2073,007-4.3%
Wyoming$18$36153417-4.3%
Maine$18$54196443-4.6%
North Carolina$18$474,35817,630-4.7%
Montana$18$46167508-4.9%
Arizona$18$489783,565-5.3%
South Carolina$18$491,9299,454-5.5%
West Virginia$17$384901,821-6.9%
Indiana$17$411,3323,398-7.3%
Utah$17$41323603-7.3%
Iowa$17$538552,544-7.5%
New Mexico$17$455852,737-7.5%
Nebraska$17$445151,433-7.6%
Louisiana$17$411,4677,382-7.6%
Missouri$17$469392,599-7.7%
Vermont$17$52122275-8.4%
Kansas$17$396451,679-8.6%
Tennessee$17$422,5499,035-8.8%
Alabama$17$361,4884,942-9.0%
Idaho$17$45228572-9.4%
Arkansas$17$461,0964,631-11.1%
Oklahoma$16$381,5686,386-12.3%
Ohio$16$432,6545,793-14.2%
Mississippi$16$401,1254,842-15.4%
Kentucky$15$471,1482,803-17.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber