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Procedure price report · Prophylactic vaccinations and inoculations

Flu shot, four-strain, preservative-free, 0.5 mL

CPT 90686the billing code this page is about

Covers a four-strain inactivated influenza vaccine with no preservative, given as a single 0.5 mL injection into the muscle; the vaccine product only, with administration billed separately.

Hospitals typically charge $30 cash for this outpatient procedure — the median across 1,638 hospitals that filed a usable cash price; the average of the middle 60% is $34. Most fall between $18 and $63 (20th–80th percentile).

Hospitals
1,638
States
49
Filings dated
Dec 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 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 1,638 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
$13$20$30$52$93

The most expensive tenth of hospitals charges at least 7.4× what the cheapest tenth charges ($13 vs $93).

How the prices are spread

$9 – $12: 53 hospitals$9$12 – $16: 125 hospitals$16 – $21: 180 hospitals$16$21 – $27: 264 hospitals$27 – $35: 229 hospitals$27$35 – $46: 199 hospitals$46 – $61: 159 hospitals$46$61 – $80: 135 hospitals$80 – $105: 78 hospitals$80$105 – $137: 55 hospitals$105median $30price bands are equal on a log scale
Hospitals per price band (1,477 of 1,638 — the bands cover the 5th to 95th percentile)
FromToHospitals
$9$1253
$12$16125
$16$21180
$21$27264
$27$35229
$35$46199
$46$61159
$61$80135
$80$10578
$105$13755

By state

The median cash price in each state, against the national median of $30.

Alaska: median $30 across 11 hospitalsAK$30Maine: 8 hospitals filed a usable price — fewer than 10, so no figureMEVermont: median $34 across 10 hospitalsVT$34New Hampshire: median $36 across 10 hospitalsNH$36Washington: median $21 across 41 hospitalsWA$21Idaho: median $19 across 15 hospitalsID$19Montana: median $29 across 19 hospitalsMT$29North Dakota: median $25 across 16 hospitalsND$25Minnesota: median $27 across 55 hospitalsMN$27Illinois: median $29 across 65 hospitalsIL$29Wisconsin: median $28 across 47 hospitalsWI$28Michigan: median $26 across 58 hospitalsMI$26New York: median $32 across 71 hospitalsNY$32Massachusetts: median $41 across 24 hospitalsMA$41Oregon: median $23 across 30 hospitalsOR$23Nevada: median $63 across 14 hospitalsNV$63Wyoming: 8 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 9 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $24 across 60 hospitalsIA$24Indiana: median $48 across 33 hospitalsIN$48Ohio: median $39 across 85 hospitalsOH$39Pennsylvania: median $28 across 63 hospitalsPA$28New Jersey: median $62 across 29 hospitalsNJ$62Connecticut: 8 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 3 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $21 across 103 hospitalsCA$21Utah: median $44 across 15 hospitalsUT$44Colorado: median $44 across 33 hospitalsCO$44Nebraska: median $23 across 44 hospitalsNE$23Missouri: median $25 across 37 hospitalsMO$25Kentucky: median $62 across 48 hospitalsKY$62West Virginia: median $40 across 14 hospitalsWV$40Virginia: median $23 across 24 hospitalsVA$23Maryland: 6 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: median $32 across 17 hospitalsAZ$32New Mexico: median $40 across 11 hospitalsNM$40Kansas: median $29 across 39 hospitalsKS$29Arkansas: median $24 across 13 hospitalsAR$24Tennessee: median $23 across 40 hospitalsTN$23North Carolina: median $18 across 44 hospitalsNC$18South Carolina: median $20 across 35 hospitalsSC$20Oklahoma: median $20 across 29 hospitalsOK$20Louisiana: median $36 across 22 hospitalsLA$36Mississippi: median $23 across 36 hospitalsMS$23Alabama: median $43 across 17 hospitalsAL$43Georgia: median $30 across 43 hospitalsGA$30Hawaii: median $48 across 14 hospitalsHI$48Texas: median $51 across 103 hospitalsTX$51Florida: median $89 across 59 hospitalsFL$89
Cash price by state, most expensive first. National median $30. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL59$89+196%$29 – $140
Nevada NV14$63+110%$17 – $101
New Jersey NJ29$62+107%$9 – $127
Kentucky KY48$62+106%$27 – $109
Texas TX103$51+71%$17 – $77
Indiana IN33$48+62%$22 – $48
Hawaii HI14$48+61%$29 – $55
Colorado CO33$44+46%$32 – $111
Utah UT15$44+46%$28 – $82
Alabama AL17$43+43%$18 – $75
Massachusetts MA24$41+37%$25 – $92
West Virginia WV14$40+35%$28 – $69
New Mexico NM11$40+32%$32 – $55
Ohio OH85$39+30%$25 – $74
New Hampshire NH10$36+20%$19 – $90
Louisiana LA22$36+20%$16 – $50
Vermont VT10$34+14%$20 – $55
New York NY71$32+7%$21 – $57
Arizona AZ17$32+6%$19 – $98
Georgia GA43$300%$18 – $78
Alaska AK11$30−1%$25 – $55
Illinois IL65$29−3%$25 – $56
Kansas KS39$29−4%$19 – $50
Montana MT19$29−5%$20 – $42
Wisconsin WI47$28−7%$26 – $47
Pennsylvania PA63$28−7%$12 – $71
Minnesota MN55$27−9%$14 – $36
Michigan MI58$26−13%$16 – $33
North Dakota ND16$25−17%$18 – $58
Missouri MO37$25−18%$14 – $53
Iowa IA60$24−20%$21 – $44
Arkansas AR13$24−21%$4 – $42
Tennessee TN40$23−23%$13 – $44
Virginia VA24$23−23%$13 – $64
Nebraska NE44$23−23%$16 – $42
Oregon OR30$23−23%$11 – $36
Mississippi MS36$23−24%$8 – $48
Washington WA41$21−31%$13 – $33
California CA103$21−31%$16 – $78
Oklahoma OK29$20−33%$18 – $34
South Carolina SC35$20−33%$16 – $55
Idaho ID15$19−37%$14 – $22
North Carolina NC44$18−40%$16 – $62
South Dakota SD9not enough hospitals filed a usable price
Connecticut CT8not enough hospitals filed a usable price
Maine ME8not enough hospitals filed a usable price
Wyoming WY8not enough hospitals filed a usable price
Maryland MD6not enough hospitals filed a usable price
Rhode Island RI3not 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 $30.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,127$31$17 – $69
Children’s29$27$14 – $51
Critical access476$29$19 – $50
Ownership
For-profit230$56$25 – $109
Government307$28$16 – $55
Non-profit1,095$28$17 – $53
System affiliation
Part of a system1,289$30$18 – $65
Independent349$30$18 – $59

Cash price vs list price

Median list price (chargemaster)$49
Median cash price$30
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

1,097 hospitals filed a usable inpatient cash price for this code. The median is $30 and the average of the middle 60% is $33; most fall between $17 and $57.

Cash price percentiles, inpatient, across 1,097 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
$13$19$30$50$83

The most expensive tenth of hospitals charges at least 6.4× what the cheapest tenth charges ($13 vs $83).

Of the 1,213 hospitals that filed this code inpatient, 1,097 gave a usable cash price; 21 carried a plausibility flag, 9 filed a number their own filing marks as not a price, 0 gave an estimate, and 86 a list price only.

How complete is this

1,638 of the 3,956 hospitals with a price file in our corpus (41%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,780 hospitals that filed this code at all gave us
Usable cash price — counted1,638
Cash price carrying a plausibility flag — shown on the compare tool, excluded here33
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded11
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded98
Hospitals that filed this code1,780

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 July 20, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 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 IIV4 VACC NO PRSV 0.5 ML IM.

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, “Flu shot, four-strain, preservative-free, 0.5 mL (CPT 90686) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-90686-flu-shot-four-strain-preservative-free-0-5-ml