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Kansas 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 $214 · 10th–90th $186–$3470%20%10th90th$214Professionalmedian $162 · 10th–90th $162–$2040%20%40%90th$162$20.0$50.0$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
$186.21 / $194.98 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $204.17
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $218.78 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $213.80 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $245.47
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $199.53