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Wisconsin rates for HCPCS 90620

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

Facilitymedian $355 · 10th–90th $240–$4680%20%10th90th$355Professionalmedian $257 · 10th–90th $214–$5130%20%10th90th$257$100.0$200.0$500.0$1.0K

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
$239.88 / $354.81 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $537.03 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $281.84 / $288.40
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $389.05 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $380.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $234.42
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $263.03 / $263.03
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $851.14
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $380.19