go back

Wisconsin rates for HCPCS 90677

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

Facilitymedian $427 · 10th–90th $316–$6310%10%20%10th90th$427Professionalmedian $363 · 10th–90th $269–$7760%10%20%10th90th$363$10.0$50.0$200.0$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
$316.23 / $416.87 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $776.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $676.08 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $724.44 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $398.11 / $812.83
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $691.83
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $616.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $316.23 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $309.03 / $309.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $691.83 / $1,023.29
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $338.84 / $977.24
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $338.84 / $489.78