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South Dakota rates for HCPCS 90621

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

Facilitymedian $209 · 10th–90th $209–$2090%50%$209Professionalmedian $219 · 10th–90th $195–$5370%20%10th90th$219$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
$208.93 / $208.93 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $218.78 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $239.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $575.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $229.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $245.47 / $269.15
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93