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Nebraska 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 / $134.90 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $120.23 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $117.49 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $154.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $239.88 / $537.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $162.18 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $138.04 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $162.18 / $173.78