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Louisiana 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 $178 · 10th–90th $162–$2140%50%10th90th$178Professionalmedian $162 · 10th–90th $148–$1910%50%10th90th$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
$162.18 / $162.18 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $181.97
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $371.54
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
$371.54 / $398.11 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $199.53