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South Dakota rates for HCPCS 90653

Iiv Adjuvanted Vaccine For Intramuscular Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $75.06 / $205.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.49 / $98.16 / $118.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.05 / $91.08 / $106.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.88 / $165.89 / $268.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.29 / $80.70 / $94.85
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.86 / $100.19 / $100.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.86 / $96.13 / $155.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $98.16 / $98.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.85 / $94.85 / $97.44
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.16 / $98.16 / $98.16
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.16 / $98.16 / $98.16