MyChart
Your insurance may or may not cover charges for clinic visits and immunizations. Please check with your insurance provider to find out what’s covered.
St. Luke's is happy to bill your insurance for services provided at our clinic, but this does not guarantee payment. You must accept full financial responsibility should your insurance decline to cover all or part of the services provided.
Pricing is subject to change.
Please note: State funded vaccines will be used for patients age 18 years and younger, when appropriate.
St. Luke's is happy to bill your insurance for services provided at our clinic, but this does not guarantee payment. You must accept full financial responsibility should your insurance decline to cover all or part of the services provided.
Pricing is subject to change.
Please note: State funded vaccines will be used for patients age 18 years and younger, when appropriate.
Administration
- Office visit fee: Contingent on services provided according to St. Luke's coding and billing policies.
- Administration fee for 1st injection: $45.00
- Administration fee for each additional injection: $28.00
Vaccinations
Costs listed are per dose.
| CPT Code | Immunization | Brand | Cost |
|---|---|---|---|
| 90589 | Chikungunya | (IXCHIQ®) | $412.50 |
| 90632 | Hepatitis A | (Havrix®) | $96.80 |
| 90746 | Hepatitis B | (Energix-B®) | $95.51 |
| 90739 | Hepatitis B | (Heplisav-B®) | $188.23 |
| 90636 | Hepatitis A/B Combination | (Twinrix®) | $129.70 |
| 90648 | Hib | $23.12 | |
| 90651 | HPV | (Gardasil®) | $430.18 |
| 90658 | Influenza | $45.00 | |
| 90662 | Influenza (HD) | $57.00 | |
| 90738 | Japanese Encephalitis | (Ixiaro®) | $323.55 |
| 86580 | Mantoux TB (tuberculin skin test) | $18.00 | |
| 90620 | Meningococcal B | (Bexsero®) | $250.87 |
| 90619 | Meningococcal ACWY | (Menquadfi®, Menveo) | $211.17 |
| 90707 | MMR | $144.61 | |
| 90611 | MPOX (formerly known as monkeypox) | (JYNNEOS®) | $405.00 |
| 90677 | Pneumococcal 20-valent Conjugate | (Prevnar 20®) | $372.37 |
| 90732 | Pneumococcal Polysaccharide | (Pneumovax 23®) | $149.28 |
| 90713 | Polio | $75.80 | |
| 90675 | Rabies | (RabAvert®) | $417.89 |
| 90678 | Respiratory Syncytial Virus (RSV) | (AbrysvoTM) | $442.50 |
| 90750 | Shingles | (Shingrix) | $296.84 |
| 90715 | Tdap | $70.78 | |
| 90714 | Tetanus/Diphtheria | $70.78 | |
| 90627 | Tick Borne Encephalitis | (TicoVacTM) | $434.15 |
| 90691 | Typhoid Injectable | (Typhim Vi®) | $149.56 |
| 90690 | Typhoid Oral | (Vivotif) | $120.49 |
| 90716 | Varicella | $221.31 | |
| 90717 | Yellow Fever | (YF-Vax) | $220.14 |
Make an appointment with St. Luke's Clinic - Travel Medicine and Immunizations