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Virginia 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
$127.55 / $127.55 / $312.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.54 / $127.55 / $184.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.46 / $122.46 / $122.46
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.30 / $93.02 / $134.99
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.32 / $143.32 / $194.26
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.66 / $136.15 / $176.73
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.66 / $136.15 / $176.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.06 / $134.99 / $144.07