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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
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $20.42 / $20.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20