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South Dakota rates for HCPCS 90691

Typhoid Vaccine Vi Capsular Polysaccharide Im

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.97 / $156.97 / $156.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.00 / $156.97 / $178.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.13 / $166.41 / $166.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.43 / $213.79 / $409.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.29 / $169.29 / $169.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.01 / $96.07 / $167.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.01 / $101.26 / $167.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $113.68 / $113.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.63 / $169.29 / $173.91
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.32 / $101.32 / $101.32
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.32 / $101.32 / $101.32