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Louisiana rates for HCPCS 90687

Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.34 / $9.34 / $9.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.34 / $10.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.44 / $10.44 / $15.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.44 / $10.44 / $10.65
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.33 / $10.33 / $10.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.33 / $10.33 / $10.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.40 / $10.99 / $13.05