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Immunizations Price Lists

Access to csv file
https://www.elliothospital.org/website/ehs-2020-price-lists/Immunizations.csv


ABCD
1
CategoryCharge CodeDescription1/1/2020
Unit Charge
2
IMMUNINZATIONS5101114RABIES IG, IM/SC $ 1,300.00
3
IMMUNINZATIONS5101262RSV MONOCLONAL ANTIBODY RECOMBINANT 50MG IM $ 975.00
4
IMMUNINZATIONS5101292VACCINA IG, IM $ 31.00
5
IMMUNINZATIONS5101212VARICELLA-ZOSTER IG, IM $ 257.00
6
IMMUNINZATIONS7710090471HC ADMINISTRATION VACCINE SINGLE INJECTION $ 22.00
7
IMMUNINZATIONS7710190471HC ADMIN IMMUN VAC/TOX $ 22.00
8
IMMUNINZATIONS7710290471HC ADMIN IMMUN VAC/TOX $ 22.00
9
IMMUNINZATIONS7710090472HC ADMINISTRATION VACCINE EA ADDL INJECTION $ 22.00
10
IMMUNINZATIONS7710190472HC ADMIN IMMUN ADD'L VAC/TOX $ 22.00
11
IMMUNINZATIONS7710290472HC INJ IMMUN ADD'L VAC/TOX $ 26.00
12
IMMUNINZATIONS7710090474HC ADMINISTRATION VACCINE EA ADDL INTRANASAL/ORAL $ 26.00
13
IMMUNINZATIONS7710290474HC IMMUNE ADMIN ORAL/NASAL ADDL $ 26.00
14
IMMUNINZATIONS5106775MENB-4C VACC 2 DOSE IM $ 175.00
15
IMMUNINZATIONS5100045HEP A VACCINE ADULT IM (PHARM) $ 110.00
16
IMMUNINZATIONS5101139HEP A VACCINE PED/ADOL2DOSE IM $ 88.00
17
IMMUNINZATIONS5101213HEPA/HEPB VACCINE ADULT IM $ 292.00
18
IMMUNINZATIONS5101118HIB VACCINE PRP-T 4 DOSE IM $ 45.00
19
IMMUNINZATIONS5153120HPV IMMUNIZATION 4 VALENT $ 315.00
20
IMMUNINZATIONS5150516HPV IMMUNIZATION 9 VALENT $ 249.00
21
IMMUNINZATIONS5101119INF VACCINE, TRIVALENT, SPLIT, PRESERV FREE 0.25ML,IM $ 40.00
22
IMMUNINZATIONS5101120INF VAC,SPLIT 0.5ML(PRESERVATIVE FREE) $ 45.00
23
IMMUNINZATIONS5101121INF VACCINE, TRIVALENT, SPLIT, 0.25ML,IM $ 47.00
24
IMMUNINZATIONS5155103FLUZONE HIGH DOSE $ 71.94
25
IMMUNINZATIONS5100096PNEUMOCOCCAL IMMUN 13 VALENT $ 438.00
26
IMMUNINZATIONS5102250FLUMIST, QUADRIVALENT, NASAL FLU VACCINE $ 72.00
27
IMMUNINZATIONS5101122RABIES VACCINE IM USE $ 850.00
28
IMMUNINZATIONS5101215RABIES VACCINE INTRADERMAL $ 500.00
29
IMMUNINZATIONS5101123ROTAVIRUS VACCINE ORAL USE 3 DOSE $ 184.00
30
IMMUNINZATIONS5102360FLUZONE QUADRIVALENT PRESERV FREE 0.25ML $ 45.00
31
IMMUNINZATIONS5102361FLUARIX QUADRIVALENT PRESERV FREE 0.5ML $ 45.00
32
IMMUNINZATIONS5101275DTAP-IPV/HIB POLIO VACCINE $ 500.00
33
IMMUNINZATIONS5101125DTAP IMMUNIZATION INDIV < AGE 7 $ 93.00
34
IMMUNINZATIONS5101127DT IMMUNIZATION INDIV AGE < 7 IM $ 99.00
35
IMMUNINZATIONS5101217RUBELLA IMMUNIZATION $ 79.00
36
IMMUNINZATIONS5100078MMR VIRUS IMMUN (PHARM) $ 110.00
37
IMMUNINZATIONS5155102COMBINED VACCINE,MMR+VARICELLA,LIVE,SC $ 110.00
38
IMMUNINZATIONS5101129POLIOMYELITIS IMMUNIZATION $ 133.00
39
IMMUNINZATIONS5100086TD IMMUN/VAC PRSRV FREE INDIV AGE 7+IM (PHA $ 57.00
40
IMMUNINZATIONS5101130TDAP INDIV AGE 7+ IM $ 80.00
41
IMMUNINZATIONS5100094PNEUMOCOCCAL IMMUN 23 VALENT $ 64.00
42
IMMUNINZATIONS5100623MENINGOCOCCAL IMM INJ (PHARM) $ 292.00
43
IMMUNINZATIONS5101131MENING VAC - GRP A, C,Y, W-135 $ 144.00
44
IMMUNINZATIONS5101219ZOSTER(SHINGLES)VACC, SUBCU $ 266.00
45
IMMUNINZATIONS5101132HEPATITIS B VACCINE (PED/ADOL) $ 39.00
46
IMMUNINZATIONS5100599HEP B VACCINE (PHARM) $ 157.00
47
IMMUNINZATIONS5106761SHINGRIX VACC RECOMBINANT IM $ 257.00
48
IMMUNINZATIONS77100G0008HC ADMINISTRATION VACCINE INFLUENZA VIRUS (FLU) $ 66.00
49
IMMUNINZATIONS77101G0008HC ADMIN IMMUN FLU VAC $ 66.00
50
IMMUNINZATIONS77102G0008HC ADMIN IMMUN FLU VAC $ 22.00
51
IMMUNINZATIONS77100G0009HC ADMINISTRATION VACCINE PNEUMOCOCCAL $ 85.00
52
IMMUNINZATIONS77101G0009HC ADMIN IMMUN PNEUMOCOCCAL VAC $ 22.00
53
IMMUNINZATIONS77100G0010HC ADMINISTRATION VACCINE HEPATITIS B $ 85.00
54
IMMUNINZATIONS77102G0010HC ADMIN IMMUN HEP B (MDCR) $ 22.00
55
IMMUNINZATIONS5100890AFLURIA VACC, 3 YRS & >, IM $ 24.00
56
IMMUNINZATIONS5101419VACCINE FLUVIRIN AGE 3+ (PHARM) $ 24.00
57
IMMUNINZATIONS5101420VACCINE FLUZONE AGE 3+ (PHARM) $ 24.00