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Illinois rates for HCPCS 90715

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $107.15 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $57.54 / $138.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $39.81 / $51.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $173.78 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $79.43 / $120.23
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $51.29 / $51.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $64.57 / $64.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $60.26