go back

Montana rates for HCPCS 90702

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

Facilitymedian $30 · 10th–90th $28–$490%50%10th90th$30Professionalmedian $68 · 10th–90th $30–$1020%50%10th90th$68$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $74.13 / $74.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $30.20 / $34.67
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $30.20 / $34.67
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $48.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $60.26 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $79.43