go back

Michigan 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 / $31.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.28 / $28.28 / $29.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.95 / $22.95 / $30.75
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.95 / $27.54 / $31.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.28 / $27.44 / $30.91