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North Dakota rates for HCPCS 90658

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $22.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $21.88 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $28.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $33.11 / $66.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $21.88 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $21.88 / $24.55