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Michigan 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 $355 · 10th–90th $170–$6610%10%10th90th$355Professionalmedian $166 · 10th–90th $155–$3020%20%40%10th90th$166$20.0$50.0$100.0$200.0$500.0$1.0K

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 / $275.42 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $165.96 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $74.13 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $354.81 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $186.21 / $616.60
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $302.00
Priority Health
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 / $616.60 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $208.93