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California rates for HCPCS 90733

Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $125.89 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $181.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $154.88 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $147.91 / $302.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $165.96 / $302.00
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $323.59 / $537.03
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $147.91 / $190.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $104.71 / $263.03
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $158.49 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $165.96 / $302.00