go back

New Hampshire 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 / $34.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $30.75
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
$24.56 / $38.02 / $72.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.28 / $24.28 / $27.92
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,920.00 / $4,735.00