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New Mexico 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
$150.60 / $150.60 / $150.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $150.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.73 / $615.03 / $1,002.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.19 / $106.49 / $125.58
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 / $137.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.89 / $113.89 / $113.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.03 / $106.57 / $137.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.94 / $137.94 / $137.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.65 / $147.65 / $177.18