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Massachusetts 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 $200 · 10th–90th $162–$4900%20%10th90th$200Professionalmedian $162 · 10th–90th $141–$2570%50%10th90th$162$100.0$500.0$2.0K$10.0K$50.0K

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
$162.18 / $162.18 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $162.18 / $208.93
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $398.11 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,888.44 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $281.84
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $616.60 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $234.42