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Arizona rates for HCPCS 90671

Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.26 / $360.44 / $949.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.00 / $300.00 / $772.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.98 / $221.98 / $221.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.24 / $855.26 / $1,311.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.19 / $219.91 / $1,661.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.49 / $269.49 / $269.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.49 / $269.49 / $269.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.63 / $287.27 / $373.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.00 / $274.89 / $275.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.14 / $288.60 / $288.74