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Cost Estimator
Monticello Clinic
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Medication
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Select a Service
Select a service.
You may need to get a specific service code from your provider.
Code
Description
0011A
Moderna Vaccine 1st Dose: 100mcg
0012A
Moderna Vaccine 2nd Dose: 100mcg
0031A
Janssen Covid-19 Vaccine Administration
11900
Injection, intralesional; up to and including seven lesions Med Admin POC
64455
Injection(s), anesthetic agent and/or steroid, plantar commo
90461
Immunization administration through 18 years of age via any
90471
Immunization administeration; 1 vaccine
90472
Each additional vaccine
90473
immunization oral administration; 1 vaccine
90473
Immunizaiton administration oral
90620
Bexsero
90620
Bexsero Order Set
90632
Hepatitis A Adult Vaccine POC
90633
Hepatitis A Peds/Adol Vaccine 2 Dose Sched Charge
90636
Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosag
90636
Hepatitis A-Hepatitis B Adult Vaccine Charge
90640
Tenivac (Tdt)
90648
Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for IM
90649
Human Papilloma virus (HPV) Vaccine POC
90651
GARDASIL 9
90651
Gardasil 9
90651
HPV (human papillomavirus vaccine)
90662
Influenza virus vaccine, split virus, preservative free, enh
90670
Pneumococcal conjugate vaccine, 13 valent, for intramuscular use
90672
INFLUENZA LIVE, NASAL MIST
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