go back

Missouri rates for HCPCS 90396

Varicella-zoster immune globulin, human, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,754.23 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,884.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,511.89 / $8,317.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,630.27 / $11,220.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,754.23 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,754.23 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,754.23 / $3,019.95