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North Dakota 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
$30.20 / $39.81 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $40.74 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $47.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $54.95 / $120.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $42.66 / $42.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $43.65 / $43.65