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Illinois 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
$125.50 / $125.50 / $138.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $153.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.80 / $568.96 / $2,072.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.03 / $155.03 / $155.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.94 / $137.94 / $137.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.94 / $137.94 / $137.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $54.19 / $204.24
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.18 / $40.85 / $44.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.65 / $162.41 / $177.18