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Maine rates for HCPCS 90634

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $31.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.41 / $27.09 / $41.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $35.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.28 / $24.28 / $42.49