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Indiana rates for HCPCS 90620

Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.74 / $537.00 / $537.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.47 / $241.74 / $378.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.99 / $474.26 / $711.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.58 / $241.87 / $333.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.87 / $335.06 / $402.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.06 / $335.06 / $385.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.58 / $265.58 / $265.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.46 / $265.58 / $689.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.13 / $267.95 / $284.56