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Missouri 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
Facility
Modifier
Low / Median / High Price
$67.16 / $79.01 / $82.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.15 / $67.16 / $79.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.04 / $112.35 / $173.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.01 / $79.01 / $79.01
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.16 / $79.01 / $296.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.09 / $79.01 / $79.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.09 / $77.98 / $79.93