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Hawaii rates for HCPCS 90733

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $130.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.94 / $137.94 / $137.94
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.88 / $132.88 / $132.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.19 / $147.65 / $221.48
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.65 / $74.65 / $87.82