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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
$16.30 / $16.30 / $16.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.99 / $13.99 / $13.99
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $18.55 / $22.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.38 / $15.12 / $16.05