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Pennsylvania 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
$37.36 / $55.38 / $110.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.27 / $41.92 / $64.59
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.31 / $55.59 / $66,603.80
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.76 / $44.42 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.84 / $39.84 / $39.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $47.32 / $47.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.32 / $47.32 / $47.32
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.84 / $122.26 / $167.38
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.31 / $53.99 / $63,947.52
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.54 / $61.47 / $176.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.34 / $41.46 / $64.44
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.39 / $488.64 / $1,003.93
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $47.32 / $47.32
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.32 / $47.32 / $47.32
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.78 / $27.78 / $32.24
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.78 / $27.78 / $32.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.25 / $49.16 / $58.99