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Wisconsin rates for HCPCS 90664

Laiv Vaccine Pandemic Formula For Intranasal Use

Insurance Carrier
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $55.00 / $85.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.79 / $23.79 / $43.50