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South Carolina 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 $200 · 10th–90th $115–$2570%20%10th90th$200Professionalmedian $162 · 10th–90th $155–$2510%20%40%10th90th$162$50.0$100.0$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
$114.82 / $199.53 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $208.93 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $138.04 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $208.93