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Illinois 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
$32.36 / $47.86 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $33.11 / $58.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $26.92 / $35.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $100.00 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $29.51 / $85.11
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.78 / $19.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $27.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $37.15 / $38.02