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South Dakota 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
$43.65 / $69.18 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $72.44 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $117.49 / $190.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $85.11 / $85.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $85.11 / $87.10
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $67.61