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Maine 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
$257.99 / $257.99 / $257.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.74 / $241.74 / $265.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.18 / $733.18 / $733.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.87 / $241.87 / $241.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.58 / $265.58 / $265.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.58 / $265.58 / $265.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.74 / $279.69 / $429.06
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.99 / $257.99 / $257.99
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.74 / $241.74 / $278.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.13 / $237.13 / $414.98