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Montana 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
Professional
Modifier
Low / Median / High Price
$110.00 / $130.00 / $217.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.48 / $101.48 / $176.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.48 / $134.47 / $134.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.48 / $101.48 / $176.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.64 / $93.28 / $137.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.66 / $135.66 / $144.07