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Missouri 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
$167.73 / $199.95 / $325.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.00 / $169.96 / $203.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.76 / $283.48 / $438.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.67 / $188.67 / $188.67
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
$169.96 / $310.69 / $707.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $196.77 / $201.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $196.77 / $208.44