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Maine 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
$43.24 / $168.10 / $416.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $57.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.09 / $123.09 / $123.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.73 / $49.73 / $49.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.60 / $54.60 / $54.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.60 / $54.60 / $54.60
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.05 / $58.05 / $58.05
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $46.06 / $70.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.36 / $142.47 / $360.99
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $49.05 / $73.58