go back

Wyoming 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 $617 · 10th–90th $617–$8130%20%40%90th$617Professionalmedian $200 · 10th–90th $170–$2340%50%10th90th$200$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $199.53 / $199.53