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Montana rates for HCPCS 90633

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

Facilitymedian $50 · 10th–90th $46–$46,7740%20%40%10th90th$50Professionalmedian $50 · 10th–90th $39–$830%20%10th90th$50$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $83.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $45.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $50.12 / $56.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $50.12 / $56.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $77.62
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $56.23 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $47.86