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Wisconsin rates for HCPCS 90703

Tetanus Toxoid Adsorbed Intramuscular

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $107.15 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $50.12 / $57.54
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $42.66 / $70.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $42.66 / $70.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00