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Virginia 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
$125.50 / $125.50 / $307.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.50 / $125.50 / $138.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.00 / $135.00 / $135.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.94 / $137.94 / $137.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.16 / $137.94 / $137.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.91 / $121.06 / $123.87
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.86 / $147.65 / $191.14
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.00 / $157.00 / $157.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.65 / $147.65 / $188.53