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Nebraska 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 / $247.74 / $350.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.82 / $237.60 / $345.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$273.89 / $357.36 / $696.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.00 / $189.00 / $189.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.88 / $265.58 / $279.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.10 / $253.44 / $1,006.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.13 / $260.83 / $284.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.75 / $250.80 / $253.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.80 / $253.80 / $253.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.13 / $267.95 / $284.39