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Wisconsin 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
$123.03 / $123.03 / $125.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $54.95 / $85.11
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $44.67