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Montana 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

Facilitymedian $355 · 10th–90th $170–$9550%20%10th90th$355Professionalmedian $182 · 10th–90th $145–$2820%20%40%10th90th$182$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $234.42 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $398.11
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $446.68 / $446.68
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $446.68 / $446.68
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $398.11 / $398.11
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $199.53 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $199.53