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Washington rates for HCPCS 90671

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

Facilitymedian $288 · 10th–90th $257–$5370%20%40%10th90th$288Professionalmedian $302 · 10th–90th $251–$7080%20%10th90th$302$5.0$20.0$100.0$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
$269.15 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $302.00 / $741.31
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $323.59
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $380.19 / $758.58
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $512.86 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $416.87
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $691.83
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $275.42 / $275.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $380.19 / $831.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $275.42 / $288.40
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $346.74