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New Hampshire 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 $191 · 10th–90th $135–$6460%10%20%10th90th$191Professionalmedian $170 · 10th–90th $158–$3020%50%10th90th$170$20.0$50.0$100.0$200.0$500.0

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
$134.90 / $169.82 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $169.82 / $257.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $645.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $181.97 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $426.58 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $302.00 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $263.03