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Rhode Island rates for HCPCS 90733

Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $125.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.37 / $216.37 / $240.41
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $140.27 / $147.65