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New York 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
$20.14 / $43.34 / $206.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.00 / $43.35 / $89.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.00 / $39.63 / $39.63
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.85 / $34.85 / $34.85
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.85 / $34.85 / $34.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.90 / $41.11 / $156.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.12 / $42.12 / $86.35
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.12 / $42.12 / $48.44
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.08 / $41.08 / $41.08
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.08 / $41.08 / $44.46
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.49 / $39.49 / $247.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.01 / $50.01 / $50.01
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.11 / $41.11 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.00 / $34.00 / $43.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $42.66 / $60.70
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.76 / $41.08 / $41.08
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.39 / $29.76 / $44.46