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Utah rates for HCPCS 90697

Dtap-Ipv-Hib-Hepb Vaccine Intramuscular

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.60 / $164.60 / $164.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.60 / $164.60 / $189.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.41 / $175.41 / $175.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.87 / $177.07 / $188.04