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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
$125.89 / $125.89 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $125.89 / $131.83
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $147.91 / $190.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $190.55