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Washington, DC 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
Facility
Modifier
Low / Median / High Price
$66.56 / $88.19 / $155.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $66.56 / $66.56
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.79 / $74.79 / $74.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.06 / $73.79 / $91.90