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Washington rates for HCPCS 90677

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

Facilitymedian $372 · 10th–90th $240–$9550%5%10%10th90th$372Professionalmedian $372 · 10th–90th $282–$1,0470%10%10th90th$372$10.0$20.0$50.0$100.0$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
$239.88 / $371.54 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $1,071.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $512.86
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $891.25
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $616.60 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $316.23 / $489.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $549.54 / $794.33
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $331.13 / $331.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $977.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $338.84 / $363.08
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $407.38