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South Dakota rates for HCPCS 90664

Influenza virus vaccine, live (LAIV), pandemic formulation, for intranasal use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70