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Wisconsin rates for HCPCS 90702

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

Facilitymedian $68 · 10th–90th $18$1620%50%10th90th$68Professionalmedian $68 · 10th–90th $44$790%50%10th90th$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 / $79.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $67.61 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $158.49 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $66.07 / $83.18
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $37.15 / $79.43
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $37.15 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $104.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $43.65 / $60.26
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $85.11 / $234.42
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $39.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $107.15