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Missouri 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 / $35.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.91 / $15.91 / $24.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.75 / $86.41 / $144.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.79 / $25.93 / $29.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.79 / $25.93 / $29.36