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South Dakota rates for HCPCS 90644

Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.95 / $24.95 / $24.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.95 / $24.95 / $24.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $27.68 / $30.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.68 / $42.17 / $68.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.00 / $32.29 / $32.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.08 / $39.02 / $41.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.31 / $39.39 / $52.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.29 / $32.29 / $38.74