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Hawaii 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
$56.23 / $66.07 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $79.43 / $97.72
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $61.66 / $64.57