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Wisconsin rates for HCPCS 90657

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

Facilitymedian $17 · 10th–90th $11$330%20%40%10th90th$17Professionalmedian $11 · 10th–90th $10$250%50%10th90th$11$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $16.60 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $19.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $23.44 / $24.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $26.92 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $28.84
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $10.96 / $22.39
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $10.96 / $22.39
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $11.75 / $17.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $14.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $25.70 / $36.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $27.54 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $10.96
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.79 / $18.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $10.96 / $25.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $11.48 / $16.60