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Louisiana 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 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $125.89
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $144.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $89.13 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $147.91 / $177.83