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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
$31.42 / $38.36 / $79.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.42 / $34.45 / $55.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.83 / $99.16 / $427.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.90 / $36.90 / $36.90
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.82 / $24.25 / $80.43
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
$17.51 / $17.64 / $19.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.54 / $17.54 / $27.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $37.13 / $38.56