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Michigan 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
$40.42 / $40.72 / $82.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.42 / $48.03 / $78.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.48 / $85.53 / $161.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.17 / $37.17 / $39.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.70 / $43.83 / $43.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.42 / $42.12 / $80.66
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.06 / $42.75 / $75.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $44.70 / $48.91