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Louisiana rates for HCPCS 90698

Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $125.89 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $125.89 / $144.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $107.15 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $138.04
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $144.54 / $165.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $147.91 / $154.88