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Montana rates for HCPCS 90621

Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $239.88 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $64,565.42 / $95,499.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $79.43 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $269.15