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Wisconsin rates for HCPCS 90689

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.58 / $20.58 / $20.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $32.00