go back

Wyoming 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 / $169.96 / $262.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.96 / $199.95 / $199.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.76 / $186.76 / $186.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.43 / $199.95 / $200.10