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South Dakota rates for HCPCS 90732

Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.64 / $176.55 / $253.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.46 / $133.47 / $221.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.97 / $135.97 / $169.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.50 / $190.86 / $365.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.79 / $128.79 / $133.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.62 / $160.16 / $189.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.42 / $153.66 / $200.21
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.02 / $119.43 / $119.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.79 / $128.79 / $132.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.47 / $133.47 / $133.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.47 / $133.47 / $133.47