go back

Nebraska 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 $191 · 10th–90th $148–$6760%10%10th90th$191Professionalmedian $200 · 10th–90th $126–$2750%10%20%10th90th$200$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $186.21 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $316.23 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $616.60 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $199.53