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Procedure price report · Prophylactic vaccinations and inoculations

Giving a vaccine by mouth or nasal spray, each added dose

CPT 90474the billing code this page is about

Payment for administering each additional oral or nasal-spray vaccine at the same visit, beyond the first; billed once per extra vaccine and does not include the vaccine product.

Hospitals typically charge $21 cash for this outpatient procedure — the median across 1,276 hospitals that filed a usable cash price; the average of the middle 60% is $23. Most fall between $12 and $42 (20th–80th percentile).

Hospitals
1,276
States
50
Filings dated
Dec 2023 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 25, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 1,276 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$9$13$21$34$85

The most expensive tenth of hospitals charges at least 9.3× what the cheapest tenth charges ($9 vs $85).

How the prices are spread

$6 – $8: 46 hospitals$6$8 – $11: 85 hospitals$11 – $15: 179 hospitals$11$15 – $20: 232 hospitals$20 – $27: 186 hospitals$20$27 – $37: 191 hospitals$37 – $50: 88 hospitals$37$50 – $67: 44 hospitals$67 – $91: 50 hospitals$67$91 – $123: 49 hospitals$91median $21price bands are equal on a log scale
Hospitals per price band (1,150 of 1,276 — the bands cover the 5th to 95th percentile)
FromToHospitals
$6$846
$8$1185
$11$15179
$15$20232
$20$27186
$27$37191
$37$5088
$50$6744
$67$9150
$91$12349

By state

The median cash price in each state, against the national median of $21.

Alaska: median $23 across 11 hospitalsAK$23Maine: median $8 across 14 hospitalsME$8Vermont: median $24 across 11 hospitalsVT$24New Hampshire: median $12 across 11 hospitalsNH$12Washington: median $24 across 43 hospitalsWA$24Idaho: median $20 across 13 hospitalsID$20Montana: median $18 across 20 hospitalsMT$18North Dakota: median $21 across 17 hospitalsND$21Minnesota: median $20 across 55 hospitalsMN$20Illinois: median $27 across 37 hospitalsIL$27Wisconsin: median $31 across 59 hospitalsWI$31Michigan: median $17 across 55 hospitalsMI$17New York: median $24 across 49 hospitalsNY$24Massachusetts: median $37 across 19 hospitalsMA$37Oregon: median $19 across 24 hospitalsOR$19Nevada: 5 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 6 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: median $33 across 16 hospitalsSD$33Iowa: median $18 across 56 hospitalsIA$18Indiana: median $9 across 32 hospitalsIN$9Ohio: median $31 across 61 hospitalsOH$31Pennsylvania: median $23 across 20 hospitalsPA$23New Jersey: median $15 across 29 hospitalsNJ$15Connecticut: 3 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 2 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $51 across 81 hospitalsCA$51Utah: median $11 across 25 hospitalsUT$11Colorado: median $25 across 26 hospitalsCO$25Nebraska: median $24 across 31 hospitalsNE$24Missouri: median $26 across 22 hospitalsMO$26Kentucky: median $14 across 14 hospitalsKY$14West Virginia: median $14 across 24 hospitalsWV$14Virginia: median $15 across 11 hospitalsVA$15Maryland: median $62 across 18 hospitalsMD$62Delaware: 3 hospitals filed a usable price — fewer than 10, so no figureDEArizona: 9 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 6 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $16 across 25 hospitalsKS$16Arkansas: 6 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $13 across 16 hospitalsTN$13North Carolina: median $22 across 27 hospitalsNC$22South Carolina: median $91 across 28 hospitalsSC$91Oklahoma: median $14 across 22 hospitalsOK$14Louisiana: median $8 across 29 hospitalsLA$8Mississippi: median $12 across 15 hospitalsMS$12Alabama: median $22 across 11 hospitalsAL$22Georgia: median $30 across 35 hospitalsGA$30Hawaii: 9 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $15 across 87 hospitalsTX$15Florida: median $116 across 28 hospitalsFL$116
Cash price by state, most expensive first. National median $21. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL28$116+444%$41 – $155
South Carolina SC28$91+327%$23 – $116
Maryland MD18$62+192%$27 – $123
California CA81$51+139%$21 – $190
Massachusetts MA19$37+74%$17 – $106
South Dakota SD16$33+54%$21 – $44
Wisconsin WI59$31+46%$19 – $33
Ohio OH61$31+44%$14 – $67
Georgia GA35$30+41%$10 – $30
Illinois IL37$27+27%$10 – $34
Missouri MO22$26+24%$15 – $32
Colorado CO26$25+16%$19 – $80
Washington WA43$24+13%$15 – $36
Nebraska NE31$24+13%$19 – $30
Vermont VT11$24+13%$16 – $32
New York NY49$24+12%$15 – $77
Pennsylvania PA20$23+8%$15 – $50
Alaska AK11$23+6%$19 – $31
North Carolina NC27$22+4%$13 – $22
Alabama AL11$22+2%$15 – $29
North Dakota ND17$210%$17 – $34
Idaho ID13$20−6%$16 – $30
Minnesota MN55$20−8%$10 – $30
Oregon OR24$19−12%$15 – $35
Iowa IA56$18−15%$13 – $27
Montana MT20$18−15%$14 – $21
Michigan MI55$17−20%$3 – $26
Kansas KS25$16−24%$10 – $20
Texas TX87$15−30%$10 – $34
Virginia VA11$15−30%$11 – $19
New Jersey NJ29$15−31%$10 – $44
West Virginia WV24$14−34%$13 – $41
Oklahoma OK22$14−36%$8 – $21
Kentucky KY14$14−37%$9 – $77
Tennessee TN16$13−40%$8 – $18
New Hampshire NH11$12−43%$7 – $19
Mississippi MS15$12−43%$6 – $18
Utah UT25$11−46%$11 – $32
Indiana IN32$9−57%$6 – $14
Louisiana LA29$8−61%$5 – $18
Maine ME14$8−62%$5 – $17
Arizona AZ9not enough hospitals filed a usable price
Hawaii HI9not enough hospitals filed a usable price
Arkansas AR6not enough hospitals filed a usable price
New Mexico NM6not enough hospitals filed a usable price
Wyoming WY6not enough hospitals filed a usable price
Nevada NV5not enough hospitals filed a usable price
Connecticut CT3not enough hospitals filed a usable price
Delaware DE3not enough hospitals filed a usable price
Rhode Island RI2not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $21.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care839$22$12 – $49
Children’s40$20$10 – $50
Critical access393$21$13 – $32
Ownership
For-profit84$23$10 – $77
Government264$22$12 – $34
Non-profit924$21$12 – $44
System affiliation
Part of a system1,037$21$12 – $43
Independent239$22$14 – $39

Cash price vs list price

Median list price (chargemaster)$33
Median cash price$21
Cash as a share of list, median hospital65%

At the typical hospital, asking for the cash price cuts the list price by about 35%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

874 hospitals filed a usable inpatient cash price for this code. The median is $23 and the average of the middle 60% is $24; most fall between $13 and $44.

Cash price percentiles, inpatient, across 874 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$10$15$23$38$91

The most expensive tenth of hospitals charges at least 9.3× what the cheapest tenth charges ($10 vs $91).

Of the 937 hospitals that filed this code inpatient, 874 gave a usable cash price; 16 carried a plausibility flag, 2 filed a number their own filing marks as not a price, 0 gave an estimate, and 45 a list price only.

How complete is this

1,276 of the 3,956 hospitals with a price file in our corpus (32%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,405 hospitals that filed this code at all gave us
Usable cash price — counted1,276
Cash price carrying a plausibility flag — shown on the compare tool, excluded here29
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded2
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded98
Hospitals that filed this code1,405

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 25, 2026; the figures were computed September 25, 2026 from filings loaded through September 25, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Prophylactic vaccinations and inoculations family.

Hospitals file this code under descriptions such as Im Adm Intransl/Oral Ea Vaccine.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Giving a vaccine by mouth or nasal spray, each added dose (CPT 90474) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-90474-giving-a-vaccine-by-mouth-or-nasal-spray-each-added-dose