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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
$40.71 / $40.71 / $53.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.71 / $40.71 / $44.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.99 / $120.99 / $120.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.63 / $39.63 / $39.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.78 / $46.03 / $70.61
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.71 / $40.71 / $53.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.71 / $40.71 / $58.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $39.56 / $59.34