go back

Maine 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
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $34.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $16.22 / $18.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $16.22 / $37.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $13.49 / $21.88