go back

South Dakota rates for HCPCS 90649

4vhpv Vaccine 3 Dose Schedule For Im Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.24 / $163.24 / $163.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.24 / $163.24 / $182.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.50 / $162.11 / $200.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.43 / $275.88 / $447.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.13 / $181.48 / $181.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.09 / $144.09 / $144.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.00 / $139.00 / $139.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.48 / $181.48 / $186.43