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Pennsylvania 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
$99.68 / $127.55 / $161.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.50 / $143.65 / $423.57
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.74 / $134.99 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.24 / $128.24 / $128.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.47 / $134.47 / $134.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.47 / $134.47 / $134.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.55 / $127.55 / $215.56
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.75 / $143.32 / $423.57
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.47 / $134.47 / $134.47
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.47 / $134.47 / $134.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.89 / $112.89 / $112.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.89 / $112.89 / $112.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.06 / $134.99 / $161.99