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Georgia 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 $195 · 10th–90th $166–$8320%20%40%10th90th$195Professionalmedian $166 · 10th–90th $151–$2240%50%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
$91.20 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $162.18 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $120.23 / $138.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $831.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $213.80 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $275.42 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $724.44 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $295.12