go back

Montana rates for HCPCS 90694

Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.29 / $67.20 / $101.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.20 / $69.22 / $100.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.89 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.99 / $121.99 / $121.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.14 / $76.14 / $121.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.99 / $121.99 / $121.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.30 / $87.99 / $133.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.38 / $71.38 / $71.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.42 / $87.42 / $92.83