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California rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $512.86 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $380.19 / $794.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $1,445.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $398.11 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $331.13 / $891.25
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $100.00 / $407.38
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $407.38 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $346.74 / $707.95
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $426.58 / $724.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $446.68 / $870.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $346.74 / $537.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $309.03 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $354.81 / $707.95