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New Jersey rates for HCPCS 90677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.12 / $312.89 / $666.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $312.89 / $312.89
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $312.89
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.68 / $842.18 / $2,030.33
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.27 / $321.27 / $321.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.98 / $298.80 / $328.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.08 / $307.55 / $307.55
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.89 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.43 / $296.43 / $296.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $302.06 / $336.51