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New Hampshire rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.52 / $312.89 / $473.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $312.89 / $312.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.95 / $563.22 / $1,419.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.08 / $280.08 / $312.89
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.29 / $508.15 / $965.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $274.60 / $334.54
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.24 / $349.30 / $3,000.00