Table 3.
Mean Reimbursements for Influenza Vaccine Purchase by State
| State | CPT code 90656, $ (%)a |
CPT code 90658, $ (%)a |
CPT code 90686, $ (%)a |
CPT code 90688, $ (%)a |
Unweighted average |
|---|---|---|---|---|---|
| CDC-published priceb | $15.67 | $14.41c | $17.76d | $16.20e | — |
| N | 127,376 | 242,138 | 810,914 | 347,719 | — |
| Overall | 16.66 (61.47) | 14.08 (43.88) | 19.68 (85.64) | 18.57 (88.49) | 17.25 |
| Wisconsin | 18.93 (84.60) | 18.03g (75.67) | 22.10 (89.47) | 21.83 (97.29) | 20.23g |
| Massachusetts | 17.08 (54.27) | 15.70 (51.50) | 23.35g (91.23) | 22.41g (86.25) | 19.63 |
| Delaware | 19.23 (89.85) | 15.68 (87.49) | 23.26 (98.82) | 19.47 (97.73) | 19.41 |
| Virginia | 19.30 (81.26) | 15.76 (86.91) | 20.35 (89.82) | 19.33 (92.10) | 18.69 |
| Ohio | 17.93 (72.45) | 15.45 (55.85) | 21.37 (91.13) | 19.84 (89.56) | 18.65 |
| Colorado | 21.77 (82.43) | 15.13 (63.03) | 18.78 (81.79) | 18.53 (92.60) | 18.55 |
| California | 18.24 (77.76) | 15.41 (46.25) | 20.59 (81.62) | 19.67 (91.50) | 18.48 |
| Oregon | 22.56g (82.20) | 14.63 (65.44) | 18.77 (79.50) | 17.88 (81.77) | 18.46 |
| Oklahoma | 17.28 (69.16) | 13.16 (29.16) | 22.73 (97.95) | 20.33 (96.29) | 18.38 |
| Arizona | 18.21 (70.52) | 15.50 (72.32) | 20.06 (71.82) | 19.69 (88.76) | 18.37 |
| Kansas | 18.49 (82.00) | 15.31 (68.21) | 20.19 (90.54) | 19.13 (93.64) | 18.28 |
| New Hampshire | 16.35 (45.80) | 15.25 (48.57) | 21.31 (87.44) | 20.16 (95.74) | 18.27 |
| Nebraska | 17.83 (66.15) | 16.58 (75.00) | 19.29 (86.50) | 19.16 (92.34) | 18.21 |
| District of Columbia | 20.29 (72.53) | 14.95 (72.82) | 18.87 (71.68) | 18.65 (56.11) | 18.19 |
| South Dakota | 17.14 (48.00) | 15.43 (37.50) | 19.65 (81.31) | 20.21 (73.44) | 18.11 |
| South Carolinaf | — | — | — | — | — |
| Pennsylvania | 15.35 (39.54) | 15.04 (46.81) | 20.66 (88.76) | 20.30 (95.77) | 17.84 |
| Montana | 16.18 (37.93) | 16.57 (75.34) | 19.91 (85.96) | 18.60 (76.81) | 17.82 |
| New Mexico | 14.23 (48.32) | 15.18 (57.87) | 20.93 (85.30) | 20.77 (83.29) | 17.78 |
| Michigan | 16.76 (87.99) | 16.24 (85.89) | 19.07 (97.43) | 18.89 (97.93) | 17.74 |
| Alabama | 17.52 (86.69) | 15.82 (83.88) | 19.33 (98.16) | 18.19 (98.94) | 17.71 |
| North Carolina | 17.79 (70.64) | 15.19 (71.33) | 20.05 (90.60) | 17.81 (88.45) | 17.71 |
| Missouri | 16.99 (64.47) | 15.04 (58.02) | 20.14 (91.49) | 18.59 (95.49) | 17.69 |
| Illinois | 17.05 (75.93) | 14.84 (56.95) | 19.81 (91.01) | 18.98 (93.61) | 17.67 |
| Indiana | 16.93 (89.14) | 14.19 (25.11) | 19.77 (83.23) | 19.32 (91.63) | 17.55 |
| Kentucky | 17.38 (90.04) | 13.74 (16.58) | 20.48 (98.12) | 18.19 (95.50) | 17.44 |
| Georgia | 16.67 (92.76) | 14.36 (18.80) | 20.12 (95.70) | 18.41 (98.28) | 17.39 |
| Iowa | 17.21 (62.39) | 14.53 (67.56) | 19.61 (92.75) | 18.06 (87.36) | 17.35 |
| Nevada | 17.05 (66.99) | 14.94 (63.31) | 18.63 (64.95) | 18.35 (84.01) | 17.24 |
| West Virginia | 14.55 (37.91) | 14.13 (32.92) | 20.58 (94.55) | 19.13 (91.19) | 17.10 |
| North Dakota | 17.10 (72.73) | 12.86 (26.32) | 20.78 (92.02) | 17.61 (72.77) | 17.09 |
| Wyoming | 15.68 (43.33) | 16.49 (81.48) | 17.02 (60.56) | 18.69 (68.52) | 16.97 |
| Maryland | 16.79 (67.56) | 14.56 (74.80) | 18.70 (84.58) | 17.55 (46.60) | 16.90 |
| New Jersey | 15.43 (30.86) | 14.03 (27.65) | 19.56 (71.36) | 17.99 (87.01) | 16.75 |
| Florida | 15.84 (45.44) | 13.67 (34.69) | 19.36 (81.06) | 17.82 (91.53) | 16.67 |
| Arkansas | 15.31 (43.06) | 14.15 (64.84) | 18.71 (96.49) | 18.30 (94.46) | 16.62 |
| Connecticut | 15.77 (44.79) | 13.37 (35.05) | 18.77 (90.06) | 17.79 (92.78) | 16.43 |
| Washington | 16.03 (48.97) | 13.90 (50.20) | 18.68 (92.75) | 16.83 (77.91) | 16.36 |
| New York | 15.35 (39.71) | 13.38 (29.48) | 18.95 (81.92) | 17.43 (86.94) | 16.28 |
| Utah | 14.90 (45.62) | 11.34 (27.13) | 19.29 (86.87) | 18.60 (90.31) | 16.03 |
| Texas | 14.26 (41.48) | 13.17 (46.14) | 18.11 (54.41) | 18.30 (72.61) | 15.96 |
| Maine | 13.08 (10.04) | 14.24 (36.69) | 18.00 (52.63) | 18.13 (82.80) | 15.86 |
| Mississippi | 14.22 (21.11) | 12.53 (7.87) | 18.44 (98.74) | 17.84 (82.26) | 15.76 |
| Idaho | 18.36 (87.73) | 12.51 (46.68) | 16.80 (43.91) | 15.30h (47.20) | 15.74 |
| Minnesota | 14.11 (29.47) | 12.87 (18.64) | 16.67h (46.46) | 18.28 (77.03) | 15.48 |
| Tennessee | 13.14 (14.52) | 12.67 (15.07) | 18.66 (94.84) | 16.80 (86.56) | 15.32 |
| Louisiana | 9.34h (5.89) | 9.10h (5.62) | 18.40 (97.81) | 17.10 (95.84) | 13.48h |
Source: 2016 MarketScan Commercial Claims and Encounters Database.
The proportion of vaccination visits with vaccine purchase reimbursements above the 2016 CDC published private sector purchase price.
The 2016 price per vaccine dose in the private sector can be accessed on the CDC vaccine price list website: www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/2016/2016–12-01.html.
The average CDC private sector list price of Afluria ($14.41) and Fluvirin ($14.41) in 2016.
The average CDC private sector list price of Fluzone Quadrivalent No-Preservative ($18.487 and $17.97) and Fluarix Quadrivalent Preservative Free ($16.82) in 2016.
The average CDC private sector list price of Fluzone Quadrivalent ($16.622) and FluLaval Quadrivalent ($15.77) in 2016.
Truven Health Analytics prohibits publication of estimates generated from MarketScan databases for the state of South Carolina.
The maximum reimbursement amount among states for which data are presented.
The minimum reimbursement amount among states for which data are presented.
CDC, Centers for Disease Control and Prevention; CPT, current procedural terminology.