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Washington 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 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $25.70 / $26.30
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $19.50 / $37.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $12.02 / $12.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $16.22
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $22.39