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New York 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 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $60.26 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $21.38 / $33.11
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $19.50
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $18.62
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $12.02 / $12.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $13.49 / $20.42
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $15.49 / $18.62
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $15.49 / $44.67