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Hawaii rates for HCPCS 90702

Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.15 / $67.15 / $74.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.02 / $74.02 / $74.02
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $17.78 / $17.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.86 / $79.01 / $99.14
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.74 / $10.74 / $12.64