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Washington, DC 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.60 / $241.41 / $383.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.60 / $164.60 / $164.60
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.15 / $187.15 / $187.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.41 / $175.41 / $175.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.13 / $177.07 / $224.51