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New Hampshire rates for HCPCS 90644

Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $25.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $30.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $41.69 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $29.51 / $33.88