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Illinois 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
$40.74 / $64.57 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $52.48 / $131.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $32.36 / $50.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $144.54 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $30.20 / $102.33
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.78 / $19.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $33.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $69.18 / $69.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $43.65 / $47.86