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Utah 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 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $15.85 / $19.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $15.14 / $23.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $16.60 / $20.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $15.14 / $16.22