go back

Wisconsin rates for HCPCS 90634

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

Facilitymedian $31 · 10th–90th $30–$660%50%10th90th$31Professionalmedian $32 · 10th–90th $30–$740%20%40%10th90th$32$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $38.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $30.20 / $64.57
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $35.48 / $64.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $35.48 / $64.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $36.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $75.86 / $102.33
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $173.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $38.90