go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$169.96 / $186.95 / $246.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.50 / $292.50 / $374.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
MVP Health Care
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 / $199.95 / $307.58