go back

Idaho 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
$125.89 / $125.89 / $138.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $141.25 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $169.82
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $125.89 / $177.83
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $125.89 / $125.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $147.91 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $165.96 / $177.83