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West Virginia 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 / $67.16 / $79.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.15 / $67.16 / $74.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.50 / $14.97 / $22.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.02 / $74.02 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.02 / $74.02 / $100.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.09 / $79.01 / $84.39