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Vermont 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
$18.10 / $18.10 / $18.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $22.00 / $29.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.57 / $53.23 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.29 / $50.29 / $50.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.10 / $22.10 / $22.10
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.29 / $50.29 / $50.29
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.10 / $22.10 / $22.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.53 / $23.24 / $26.37