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New Hampshire rates for HCPCS 90657

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $12.30 / $16.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $28.84 / $47.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $11.22
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 / $18.20 / $20.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $10.00 / $11.75