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Washington rates for HCPCS M0201

Administration Of Pneumococcal Influenza Hepatis B And/Or Covid-19 Vaccine Inside A Patients Home; Reported Only Once Per Individual Home Per Date Of Service When Such Vaccine Administration(S) Are Performed At The Patients Home (Desc Rvsd 1/1/2024)

Insurance Carrier
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.36 / $109.60 / $211.40
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.36 / $76.22 / $102.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.89 / $31.89 / $31.89
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.35 / $41.54 / $44.53
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.66 / $46.66 / $49.36
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.67 / $77.16 / $97.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.01 / $109.60 / $209.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.72 / $102.72 / $102.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.45 / $50.50 / $99.14