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Wisconsin rates for HCPCS 90622

Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.09 / $0.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $85.11