go back

Louisiana 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 / $169.96 / $277.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.96 / $169.96 / $186.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.95 / $189.95 / $284.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.95 / $189.95 / $193.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.60 / $115.60 / $115.60
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.96 / $188.43 / $200.10