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Alaska rates for HCPCS 90633

Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.86 / $29.86 / $29.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.89 / $40.71 / $44.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.15 / $34.15 / $34.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.61 / $39.13 / $39.13
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.64 / $63.64 / $100.01
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.89 / $23.89 / $62.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.15 / $63.18 / $148.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.00 / $35.15 / $62.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $40.24 / $42.66