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California rates for HCPCS 90647

Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.42 / $32.35 / $112.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.42 / $32.35 / $57.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.10 / $37.45 / $45.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.19 / $36.54 / $70.39
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.06 / $31.98 / $47.21
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.74 / $35.74 / $89.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.00 / $56.00 / $393.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.51 / $100.00 / $133.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.97 / $35.25 / $46.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.81 / $35.25 / $35.25
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.83 / $38.78 / $50.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.72 / $37.61 / $68.59