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West Virginia 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 / $138.04 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $66.07 / $154.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38,018.94 / $93,325.43 / $123,026.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $338.84 / $338.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $138.04 / $141.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $79.43 / $83.18