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Arizona 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 $437 · 10th–90th $148–$9550%5%10th90th$437Professionalmedian $166 · 10th–90th $148–$3390%20%10th90th$166$100.0$200.0$500.0$1.0K

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
$177.83 / $218.78 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $588.84 / $1,047.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $316.23 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $309.03 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $234.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $616.60 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $199.53