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Wisconsin rates for HCPCS 90733

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

Facilitymedian $126 · 10th–90th $89$3090%50%10th90th$126Professionalmedian $135 · 10th–90th $126$2140%50%10th90th$135$100.0$200.0$500.0

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
$125.89 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $154.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $295.12 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $186.21
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $295.12
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $537.03
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $234.42