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Montana rates for HCPCS 90714

Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.00 / $83.70 / $116.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.01 / $37.36 / $62.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.77 / $38.77 / $85.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.77 / $47.32 / $47.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.77 / $38.77 / $85.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.54 / $40.54 / $52.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.74 / $47.74 / $50.70