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South Dakota rates for HCPCS 90620

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

Facilitymedian $234 · 10th–90th $195–$2630%50%10th90th$234Professionalmedian $234 · 10th–90th $209–$4270%50%10th90th$234$200.0$500.0

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
$194.98 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $229.09 / $426.58
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $660.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $263.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $263.03 / $302.00
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42