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South Dakota rates for HCPCS 90671

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

Facilitymedian $263 · 10th–90th $214–$2690%50%10th90th$263Professionalmedian $263 · 10th–90th $245–$3550%50%10th90th$263$200.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $263.03 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $436.52 / $707.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $263.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $309.03
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $269.15