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Maine 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 / $53.70 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $50.12 / $72.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $46.77 / $52.48
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $53.70
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $47.86 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $39.81 / $69.18