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Indiana rates for HCPCS 90634

Hepatitis A vaccine (HepA), pediatric/adolescent dosage-3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.75 / $30.75 / $30.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $30.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.00 / $36.00 / $69.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.60 / $36.00 / $51.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.84 / $26.84 / $29.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.84 / $29.52 / $29.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.41 / $23.41 / $47.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.28 / $24.28 / $29.40