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Montana rates for HCPCS 90670

Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.32 / $168.32 / $375.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.00 / $283.77 / $402.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.82 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.50 / $294.50 / $680.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.60 / $253.60 / $294.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.50 / $294.50 / $680.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.60 / $279.89 / $365.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.57 / $291.52 / $309.58