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Ohio 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 / $151.36 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $141.25 / $234.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $218.78
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $218.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $177.83 / $251.19
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $147.91 / $177.83