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Indiana 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
$0.02 / $0.02 / $125.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $125.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $135.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.75 / $135.00 / $191.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.65 / $84.32 / $84.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.32 / $84.32 / $84.32
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 / $379.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.65 / $147.65 / $177.18