go back

South Dakota rates for HCPCS 90656

Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $53.70 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $23.99 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $23.44 / $29.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $33.11 / $63.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $22.91 / $23.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $26.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $23.44 / $25.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $23.44 / $25.12
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $23.44 / $23.44