CPT 90658

Vaccine Product

Current code20 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

Prices for CPT 90658 by hospital
Hospital	Medicaid (state program) rates (lowest – highest)	Cash price	List price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27	—	$2.80	$7.00
Cascade Medical CenterLeavenworth	$22.971 plan	$34.40	$43.00
Island HospitalAnacortes	—	$16.00 – $18.00	$16.00 – $18.00
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27	—	$2.80	$7.00
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27	—	$2.80	$7.00
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27	—	$2.80	$7.00
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27	—	$2.80	$7.00
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27	—	$2.80	$7.00
Three Rivers HospitalBrewster	$25.20 – $36.401 plan	$36.00 – $52.00	$36.00 – $52.00
Virginia Mason Medical CenterSeattle	—	$11.22 – $28.18	$22.00 – $55.25

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.