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Montana rates for HCPCS 90700

Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.71 / $96.71 / $96.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.35 / $36.32 / $58.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.82 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.65 / $33.65 / $58.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.14 / $33.14 / $33.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.65 / $33.65 / $58.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.32 / $31.27 / $40.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.89 / $33.89 / $35.99