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Oklahoma 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 $148 · 10th–90th $100–$1860%20%10th90th$148Professionalmedian $162 · 10th–90th $155–$2000%20%40%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
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $186.21 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $186.21 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $190.55 / $199.53