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Nebraska rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.89 / $387.57 / $585.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.05 / $340.00 / $505.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.69 / $354.24 / $480.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.52 / $350.69 / $354.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.55 / $318.83 / $398.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.02 / $329.18 / $1,176.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $302.06 / $334.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.74 / $375.48 / $402.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.74 / $375.48 / $447.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $302.06 / $411.90