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New Hampshire 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 / $10.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.34 / $9.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.02 / $17.75 / $47.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.40 / $9.40 / $9.40
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $16.95 / $32.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.44 / $10.44 / $12.01
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.80 / $12.26 / $3,000.00