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Indiana 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
$169.96 / $312.33 / $699.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.00 / $169.96 / $192.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.09 / $333.50 / $500.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.57 / $170.09 / $237.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.11 / $234.11 / $304.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.11 / $234.11 / $269.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.47 / $186.76 / $484.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $188.43 / $200.10