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Louisiana rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.73 / $364.77 / $536.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $312.89 / $438.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.19 / $344.19 / $516.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.19 / $344.19 / $351.07
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.81 / $42.81 / $42.81
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.63 / $310.30 / $334.54