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Nebraska 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
$120.88 / $169.96 / $355.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.52 / $169.96 / $265.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.69 / $342.44 / $696.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.63 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.00 / $115.00 / $115.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.88 / $186.09 / $186.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.40 / $174.25 / $707.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $183.43 / $200.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.43 / $178.33 / $480.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.43 / $178.33 / $524.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $183.43 / $199.95