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Wisconsin 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 $309 · 10th–90th $170–$4070%10%10th90th$309Professionalmedian $200 · 10th–90th $151–$4900%10%20%10th90th$200$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$169.82 / $309.03 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $354.81 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $177.83 / $199.53
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $199.53 / $562.34
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $275.42 / $346.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $190.55 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $64.57 / $165.96
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $616.60 / $870.96
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $602.56
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $190.55 / $269.15