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Wisconsin 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
$134.90 / $239.88 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $173.78 / $478.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $288.40 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $162.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $275.42 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $169.82 / $346.74
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $134.90 / $194.98
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $134.90 / $245.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $141.25 / $208.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $302.00 / $436.52
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $131.83 / $416.87
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $181.97 / $223.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $134.90 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $131.83 / $204.17