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Louisiana 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 / $15.85 / $16.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $16.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $14.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $14.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $12.02 / $13.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $13.49 / $16.22