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New York 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 $331 · 10th–90th $162$9120%20%10th90th$331Professionalmedian $166 · 10th–90th $151$2630%50%10th90th$166$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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 / $346.74 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $851.14
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $371.54
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $177.83
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $190.55 / $295.12
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $218.78
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $181.97 / $251.19
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $199.53
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $199.53