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North Carolina 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
$26.00 / $44.46 / $117.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.25 / $45.31 / $73.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.19 / $35.19 / $58.41
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 / $46.80
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.25 / $38.43 / $51.11
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $39.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.63 / $69.83 / $69.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $42.66 / $61.32
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.66 / $100.00 / $100.00