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Tennessee rates for HCPCS 90677

Pcv20 Vaccine For Intramuscular Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.59 / $301.91 / $398.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.08 / $312.89 / $432.99
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.00 / $375.00 / $375.00
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.50 / $658.74 / $1,176.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.60 / $274.60 / $334.54