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Alabama rates for HCPCS 90696

Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $72.44 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $60.26 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $44.67 / $60.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $109.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $186.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $74.13 / $79.43