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Pennsylvania rates for HCPCS 90696

Dtap-Ipv Vaccine Child 4-6 Yrs For Im Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.45 / $66.56 / $263.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.89 / $85.20 / $181.43
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.34 / $76.88 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.04 / $73.04 / $73.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.70 / $28.70 / $28.70
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.21 / $66.56 / $133.56
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.89 / $85.20 / $197.68
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.07 / $60.07 / $60.07
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.07 / $60.07 / $60.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.70 / $76.58 / $91.90