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New York rates for HCPCS 90461

Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (List separately in addition to code for primary procedure)

Facilitymedian $48 · 10th–90th $3–$1230%10%20%10th90th$48Professionalmedian $52 · 10th–90th $10–$1290%10%10th90th$52$1.0$10.0$100.0$1.0K$10.0K

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
$3.39 / $48.98 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $53.70 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $14.79 / $26.92
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $17.78
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $17.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $14.79 / $40.74
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $10.96 / $63.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $15.14 / $26.92
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $9.77 / $18.62
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $21.38 / $45.71
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $24.55 / $25.12
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $41.69 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $14.45 / $50.12
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $9.33 / $17.38
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.77 / $18.62