go back

North Dakota 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 $162 · 10th–90th $162–$2240%50%90th$162Professionalmedian $170 · 10th–90th $155–$2090%20%40%10th90th$170$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 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $169.82 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $489.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $186.21 / $199.53