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Tennessee 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
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $131.83 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $223.87 / $269.15