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New Mexico 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
$46.80 / $46.80 / $46.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.26 / $40.90 / $52.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.37 / $25.82 / $41.21
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 / $43.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.24 / $30.58 / $43.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $47.47