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New Hampshire 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
$16.30 / $44.50 / $44.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.00 / $24.00 / $24.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.99 / $13.99 / $13.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.99 / $13.99 / $13.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $22.90 / $43.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.38 / $13.38 / $15.39
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.87 / $16.20 / $23.88