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Maine 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
$67.16 / $73.87 / $74.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.34 / $204.34 / $204.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.41 / $67.41 / $67.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.02 / $74.02 / $74.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.02 / $74.02 / $74.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.16 / $77.70 / $119.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.15 / $73.87 / $77.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.18 / $66.09 / $99.14