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Arkansas rates for HCPCS 90697

Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use

Facilitymedian $166 · 10th–90th $162–$1660%50%10th$166Professionalmedian $162 · 10th–90th $155–$2000%50%10th90th$162$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $199.53
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $177.83 / $199.53