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Nebraska 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
$33.24 / $40.65 / $64.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.50 / $46.50 / $66.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.46 / $42.89 / $256.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.75 / $42.46 / $42.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.88 / $43.83 / $47.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.22 / $52.49 / $169.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.99 / $42.89 / $46.79
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.51 / $48.24 / $53.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $49.20 / $65.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $43.52 / $46.68