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Michigan 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 / $16.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $30.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $11.22 / $11.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $43.65 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $20.42 / $20.42
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $44.67 / $50.12
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $17.38 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $12.02 / $12.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $15.85 / $16.60