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West Virginia 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
$168.49 / $255.68 / $376.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.19 / $169.96 / $211.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.88 / $226.01 / $328.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.48 / $507.48 / $507.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.96 / $186.76 / $186.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.76 / $186.76 / $239.61
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.82 / $173.83 / $399.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.75 / $199.95 / $212.92