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Washington rates for HCPCS 90702

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

Facilitymedian $35 · 10th–90th $35–$790%20%40%90th$35Professionalmedian $68 · 10th–90th $68–$790%50%90th$68$5.0$10.0$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
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $141.25 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $2.69 / $7.08
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $34.67 / $34.67
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $79.43 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $79.43 / $79.43
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61