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Alaska rates for HCPCS 90677

Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.46 / $360.30 / $723.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.46 / $312.89 / $344.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.55 / $307.55 / $307.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.68 / $264.68 / $264.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $312.89 / $1,007.54
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.28 / $439.28 / $690.29
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.16 / $181.16 / $181.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$264.68 / $439.28 / $1,035.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.84 / $307.55 / $339.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $274.60 / $334.54