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Wisconsin rates for HCPCS 90664

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

Facilitymedian $20 · 10th–90th $20–$200%50%100%$20Professionalmedian $123 · 10th–90th $24–$1260%20%40%10th90th$123$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $44.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95