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West Virginia 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 $162 · 10th–90th $162–$2340%50%90th$162Professionalmedian $162 · 10th–90th $138–$2140%50%10th90th$162$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
$162.18 / $162.18 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $162.18 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $851.14
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $199.53 / $213.80