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Iowa 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 $155 · 10th–90th $155–$1860%50%90th$155Professionalmedian $174 · 10th–90th $151–$2690%20%10th90th$174$100.0$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
$123.03 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $154.88 / $190.55
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $186.21 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $177.83 / $186.21
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $190.55 / $199.53
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88