Last updated: March 2026
How Much Does Pneumonia Vaccine (Pneumococcal) Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| PCV20 (Prevnar 20) | $150 – $250 | $0 – $40 |
| PCV15 (Vaxneuvance) | $100 – $200 | $0 – $30 |
| PPSV23 (Pneumovax 23) | $100 – $180 | $0 – $30 |
CPT/ADA Code: 90677
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Preventive care — covered at no cost for recommended age groups under ACA plans
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
Pneumonia vaccines cost $100 to $250 per dose without insurance. They are covered at no cost under ACA-compliant plans for recommended populations.
The CDC recommends pneumococcal vaccination for all adults 65+, children under 5, and people with certain medical conditions or risk factors.
Most adults 65+ need one dose of PCV20. Those who received PCV15 also need PPSV23. Your doctor will recommend the right schedule.