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Nebraska 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
$16.22 / $16.60 / $16.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $27.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $19.50 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $19.05 / $19.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $15.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $16.98 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $14.79 / $16.22
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $11.75 / $25.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $14.79 / $15.85