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South Dakota 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
$18.20 / $56.23 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $23.44 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $28.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $30.90 / $54.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $24.55 / $24.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $22.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $24.55 / $25.12
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95