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Indiana 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 $251 · 10th–90th $166–$3890%20%10th90th$251Professionalmedian $162 · 10th–90th $126–$3020%50%10th90th$162$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$165.96 / $245.47 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $257.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $323.59
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $512.86 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $223.87