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Wisconsin 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
$66.56 / $66.56 / $84.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.80 / $84.11 / $198.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.08 / $64.08 / $74.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.36 / $145.63 / $208.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.13 / $62.96 / $76.41
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.56 / $74.79 / $74.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.56 / $88.36 / $207.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.70 / $71.98 / $101.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $65.00 / $155.18
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.56 / $74.79 / $74.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.63 / $272.63 / $272.63
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.34 / $69.81 / $88.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.70 / $71.98 / $104.47