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Wisconsin rates for HCPCS 90713

Poliovirus Vaccine Inactivated Subq/Im

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.64 / $79.69 / $284.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.75 / $52.78 / $147.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.62 / $45.62 / $53.53
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.23 / $47.23 / $47.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.10 / $101.86 / $145.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.03 / $45.44 / $53.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.12 / $47.64 / $53.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.12 / $47.64 / $53.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.73 / $50.54 / $71.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $65.00 / $96.05
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.12 / $47.64 / $53.53
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.31 / $57.82 / $80.30
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.33 / $191.33 / $191.33
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.10 / $50.10 / $50.10
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.24 / $43.24 / $43.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.73 / $50.54 / $73.36