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Texas rates for HCPCS 90733

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

Facilitymedian $263 · 10th–90th $123–$5620%5%10%10th90th$263Professionalmedian $151 · 10th–90th $126–$1660%20%40%10th90th$151$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $288.40 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $147.91 / $147.91
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $478.63
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $213.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $147.91 / $223.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $165.96 / $173.78