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Maryland rates for HCPCS 90671

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $269.15 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $269.15 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $269.15 / $288.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19