go back

Illinois rates for HCPCS 90655

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $16.22 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $34.67
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $11.22 / $11.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $79.43 / $301,995.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $17.78 / $17.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $23.44 / $61.66
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.78 / $19.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $21.38 / $21.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $14.79 / $16.22