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New Mexico 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
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $21.88 / $29.51
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $22.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $74.13 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $26.30 / $26.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $15.85 / $43.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $23.99 / $23.99