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Vermont 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
$66.07 / $173.78 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $64.57 / $79.43