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Utah 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
$129.91 / $169.96 / $294.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.37 / $181.00 / $264.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.41 / $188.43 / $200.10