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South Dakota rates for HCPCS 90677

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

Facilitymedian $389 · 10th–90th $309$5130%10%20%10th90th$389Professionalmedian $316 · 10th–90th $282$4680%20%40%10th90th$316$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $309.03 / $467.74
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $851.14
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $316.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $363.08
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23