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Michigan 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 / $125.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $138.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.26 / $274.27 / $518.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.22 / $119.22 / $125.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.94 / $137.94 / $169.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.50 / $147.65 / $147.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $147.65 / $177.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.65 / $166.84 / $177.18