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Arizona rates for HCPCS 90734

Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.80 / $312.00 / $350.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.05 / $178.46 / $408.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.57 / $594.59 / $941.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.97 / $159.96 / $1,059.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.93 / $199.95 / $333.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.43 / $199.95 / $200.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.43 / $199.95 / $200.10