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New Hampshire 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 / $141.25 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $154.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $208.93 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $147.91 / $169.82