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Utah 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
$22.91 / $33.88 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $22.91 / $28.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $22.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $15.14 / $23.44
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $23.99 / $23.99
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $23.44 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $25.12 / $25.12