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Hawaii rates for HCPCS 90671

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.00 / $272.80 / $929.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.49 / $269.49 / $269.49
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.74 / $259.74 / $259.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.26 / $313.38 / $365.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.60 / $304.27 / $360.93
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.86 / $226.89 / $240.66