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South Dakota 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 $166 · 10th–90th $135–$1860%50%10th90th$166Professionalmedian $166 · 10th–90th $148–$2340%20%40%10th90th$166$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 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $162.18 / $234.42
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $213.80
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96