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Kansas 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 / $79.43 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $75.86 / $112.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $52.48 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $87.10 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $70.79 / $81.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $75.86 / $75.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $75.86 / $79.43