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Utah 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
$35.39 / $40.72 / $96.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.26 / $46.00 / $65.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.83 / $43.83 / $43.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.58 / $44.70 / $47.47