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Maine 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 / $236.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.96 / $169.96 / $186.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.57 / $515.57 / $515.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $170.09 / $170.09
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.96 / $196.64 / $301.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.68 / $236.68 / $236.68
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.96 / $169.96 / $195.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.74 / $166.75 / $250.13