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Maine rates for HCPCS 90686

Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $88.64 / $164.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $22.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.88 / $26.94 / $70.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.00 / $21.00 / $21.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.10 / $22.10 / $22.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.10 / $22.10 / $22.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.35 / $25.86 / $39.67
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $40.29 / $164.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $22.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.53 / $22.35 / $33.53