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Florida 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 / $164.60 / $190.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.51 / $164.60 / $250.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.41 / $175.41 / $175.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.41 / $175.41 / $175.41
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.97 / $158.97 / $158.97
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.00 / $172.00 / $172.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.69 / $156.69 / $197.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.87 / $153.87 / $153.87