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Indiana rates for HCPCS 90689

Influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.00 / $133.00 / $133.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.90 / $22.90 / $44.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.10 / $22.90 / $30.85
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.77 / $37.60 / $38,015.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.23 / $30.23