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Idaho rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.80 / $372.35 / $744.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.04 / $372.35 / $996.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.55 / $307.55 / $307.55
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
$198.60 / $331.67 / $447.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $391.13 / $391.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.08 / $446.88 / $664.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.31 / $362.31 / $370.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.30 / $329.52 / $334.54