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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
$16.22 / $18.20 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $16.22
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
$23.99 / $23.99 / $27.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $23.44 / $26.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $13.49 / $15.49