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Wyoming 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
$66.56 / $102.60 / $179.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.57 / $74.79 / $74.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.36 / $70.36 / $70.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.06 / $76.44 / $76.58