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South Dakota rates for HCPCS 90677

Pcv20 Vaccine For Intramuscular Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.89 / $445.14 / $545.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.72 / $312.89 / $427.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.83 / $318.83 / $398.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.37 / $528.79 / $857.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.06 / $302.06 / $312.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.48 / $375.48 / $402.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.76 / $375.48 / $447.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.95 / $279.95 / $279.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.04 / $302.06 / $310.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.89 / $312.89 / $312.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.89 / $312.89 / $312.89