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Pennsylvania 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 $55 · 10th–90th $5–$2690%10%20%10th90th$55Professionalmedian $65 · 10th–90th $15–$1410%10%10th90th$65$5.0$20.0$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
$5.01 / $38.90 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $64.57 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $14.13 / $16.98
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $22.39 / $24.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $12.02 / $15.85
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $14.79 / $14.79
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $70.79 / $89.13
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $15.85
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.25 / $15.85
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $436.52 / $549.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $13.18 / $21.38