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Florida 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
$66.07 / $81.28 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $66.07 / $117.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $60.26 / $69.18
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 / $70.79
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $63.10 / $63.10
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $89.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $79.43
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66