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Maine rates for HCPCS 90657

Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $17.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $12.88 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $12.88 / $14.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $11.75 / $16.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $10.00 / $17.38