Vaccines are one of the few corners of U.S. healthcare with a published national price anchor: every August the CDC posts the private-sector price manufacturers charge for each vaccine, dose by dose. What you actually pay without insurance is that number plus whatever markup and administration fee the pharmacy or clinic adds, which is why the same Tdap shot can be $60 with a coupon or $90 at full retail.
This guide covers the shots adults most often need to pay for out of pocket: tetanus boosters after an injury or for work, Shingrix for shingles, TB tests for jobs and school, hepatitis and HPV series, MMR for school or employment proof, and pneumonia vaccines. All prices below were researched in August 2026 and re-verified against the same sources on September 2, 2026.
What Do Vaccines Cost Without Insurance?
“Low” is the cheapest published price we could open, which is usually the CDC’s manufacturer list price (adult list dated August 3, 2026, page reviewed September 1, 2026) but is sometimes lower at a warehouse club. “Average” and “High” reflect real cash prices: Costco Pharmacy’s published immunization list (revised August 10, 2026), GoodRx coupon and retail prices as of August 28, 2026, San Francisco’s health department immunization clinic (AITC) menu with prices effective July 1, 2026, and BetterCare’s TB testing survey. Remember that multi-dose series multiply the per-dose price.
| Vaccine or test (per dose) | Low | Average | High |
|---|---|---|---|
| Tdap (tetanus-diphtheria-pertussis) | $51 | $60-$87 | $90 |
| Td (tetanus-diphtheria booster) | $46 | $65 | $86 |
| Shingrix, shingles (2 doses needed) | $207 (Costco) | $243-$255 | $289 |
| TB skin test | $10-$40 (health dept) | $58 | $175 |
| TB blood test (IGRA) | $91 (health dept) | $150-$250 | $350 |
| Hepatitis A (2 doses needed) | $78 (Costco) | $84-$118 | $142 (Twinrix combo) |
| Hepatitis B (2-3 doses needed) | $72 | $75-$96 | $166-$188 (Heplisav-B) |
| HPV, Gardasil 9 (2-3 doses needed) | $285 (Costco) | $329-$366 | $366+ |
| MMR (measles-mumps-rubella) | $98 | $120 | $141 |
| Pneumonia, PCV20 (Prevnar 20) | $259 (Costco) | $299-$310 | $321 |
| Pneumonia, Pneumovax 23 | $117 | $120-$130 | $135 |
A few things jump out. The series vaccines are where budgets break: HPV at $285-$366 per dose means $570-$1,098 for a full course at cash prices, and the two-dose Shingrix series lands around $414-$580. Meanwhile the shots people most commonly walk in for, tetanus boosters and TB tests, are double-digit purchases almost everywhere, and cheaper still at public clinics.
The tetanus numbers deserve a closer look since that is the most common unplanned vaccine purchase. The CDC lists Adacel and Boostrix (the two Tdap brands) at $50.14-$51.08 per dose for 2026-2027. GoodRx shows Adacel at $60.16 with a free coupon against a $90.39 average retail price. San Francisco’s AITC clinic charges $87, or a flat $26 administration fee for income-eligible uninsured patients. So a realistic national cash range is $50-$90, with $26-or-less available through public health programs.
Warehouse clubs are the one retail channel that consistently undercuts both drugstores and the CDC list price, and Costco publishes its whole menu. As of its August 10, 2026 revision, Costco Pharmacy charges $57.99 for Tdap (Boostrix), $206.99 for Shingrix, $284.99 for Gardasil 9, $258.99 for Prevnar 20, $126.99 for Pneumovax 23, $77.99 for hepatitis A (Havrix), $79.99 for hepatitis B (Engerix-B), and $136.99 for the Twinrix combination. On Shingrix, Gardasil 9, and Prevnar 20 those prices sit below what the manufacturer charges providers on the CDC list, which makes a club membership pay for itself on a single series.
For TB testing, the private-market range is wide: BetterCare’s 2025 data puts skin tests at $50-$175 and blood tests at $150-$350. San Francisco’s health department charges $58 for a skin test including the reading visit and about $91 all-in for the blood test ($61 test plus $30 blood draw), which is a good benchmark for what health departments charge nationally. Note that healthcare and school jobs sometimes require a two-step skin test (two tests one to four weeks apart), which doubles the price, so ask exactly which test your employer needs before paying.
If you only need to prove you were already vaccinated, a blood titer test can be cheaper than revaccinating. San Francisco’s clinic prices an MMR immunity panel at $100 and a hepatitis B panel at $100, plus the $30 blood draw. Against a $141 MMR dose or a full hepatitis B series, checking immunity first sometimes wins, and many employers accept titers in place of shot records.
What Drives the Price
The manufacturer list price. Vaccines have real, published floor costs. Most sellers cannot discount Shingrix much because every provider pays GSK roughly $243 a dose, which is why Costco’s $206.99 is the exception rather than the rule. When a vaccine is expensive everywhere, this is why.
How many doses the series needs. Shingrix takes two doses, hepatitis B takes two or three, HPV takes two or three depending on age at the first dose. Always multiply the per-dose price before committing, and ask whether the clinic charges the administration fee on every visit.
Retail markup vs. public health pricing. Pharmacies add margin and a per-shot administration fee on top of the list price. Health department clinics often charge only a flat fee (San Francisco: $26, waivable) for eligible uninsured patients because federal contract pricing and public funding absorb the vaccine cost.
Brand within a category. Two Hepatitis B examples: standard Engerix-B lists at $75.10 per dose but requires three doses, while two-dose Heplisav-B lists at $165.85 per dose. The cheaper brand per dose is not always the cheaper series, so ask the provider to price the whole course both ways.
Combination products. Twinrix combines hepatitis A and B in one series and lists at $141.60 per dose, which can beat buying both series separately if you need both.
Cash Price vs. Insurance
ACA-compliant insurance covers all CDC-recommended vaccines free as in-network preventive care, so if you have real coverage, use it and pay nothing. The cash market exists for the uninsured, for people on non-ACA plans (short-term plans and sharing ministries typically skip vaccines), and for shots tied to employment requirements that insurance sometimes refuses to code as preventive, like pre-employment TB tests.
One quirk worth knowing: TB tests for a job are frequently not covered even by good insurance because they are occupational, not preventive. That makes the health department price the relevant number for almost everyone, insured or not.
If a hospital gave you a tetanus shot as part of an ER or urgent care visit and the bill looks inflated, that is a billing problem more than a vaccine problem; see our guides on reading an itemized hospital bill and urgent care costs.
How to Pay Less
Start with your county health department. This is the single best move for nearly every vaccine on this list. Most health departments run immunization clinics with flat administration fees in the $10-$40 range for uninsured adults, and San Francisco’s published menu ($26 flat fee, waivable if you cannot pay) is typical of the model. Call before assuming a price.
Use a community health center. Federally funded health centers vaccinate on sliding-scale fees based on income. Our guide to free clinics and sliding-scale care covers how to find one near you.
Kids under 19: Vaccines for Children. The federal VFC program provides every routine childhood vaccine (Tdap, HPV, MMR, hepatitis, flu, and more) free to children who are uninsured, underinsured, Medicaid-eligible, or American Indian/Alaska Native. Providers may charge an administration fee but must waive it if the family cannot pay. This turns a $658+ HPV series into $0.
Apply to manufacturer patient assistance programs. GSK’s program provides Shingrix free to income-qualified uninsured adults, and Sanofi and Merck run similar programs for their vaccines (Adacel, Gardasil 9, and others), per the assistance notes on GoodRx’s vaccine pages. These are the difference between a $580 shingles series and a free one.
Price a warehouse club. Costco publishes a flat national price list for every routine adult vaccine and does not require insurance, and on Shingrix and Gardasil 9 it beats both the drugstores and the CDC list price. Membership is not required to use the pharmacy in most states, though member pricing may not apply.
Run coupons before paying retail. Free discount cards knock vaccine prices down meaningfully: $90 retail Adacel drops to about $60, and $289 retail Shingrix drops to about $254 per dose. See GoodRx vs. SingleCare for how to use them at the pharmacy counter.
Price the whole series, then pick the venue. For multi-dose vaccines, a $30-per-dose difference compounds. Getting all three Gardasil 9 doses at a health center instead of a retail pharmacy can save several hundred dollars.
Bottom Line
Single boosters like tetanus are a $50-$90 cash purchase at retail and often $26 or less through public health clinics. The expensive problems are the series: budget $414-$580 for Shingrix and $570-$1,100 for adult HPV at cash prices, shop a warehouse club before a drugstore, or eliminate those numbers entirely through health departments, VFC for kids, and manufacturer assistance programs. If flu season is what brought you here, our flu shot cost guide has chain-by-chain prices, and if a required physical comes with your required shots, see what a physical exam costs without insurance.