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Pennsylvania rates for HCPCS 90396

Varicella-zoster immune globulin, human, for intramuscular use

Facilitymedian $2,344 · 10th–90th $2,239–$3,8900%50%10th90th$2,344Professionalmedian $2,344 · 10th–90th $2,344–$2,3440%50%$2,344$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,137.96 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $9,549.93 / $10,232.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $169.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,884.03 / $3,630.78