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Indiana 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 / $42.22 / $73.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.18 / $32.35 / $76.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.04 / $62.94 / $94.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $31.19 / $44.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.77 / $21.77 / $28.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.77 / $21.77 / $27.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.33 / $35.25 / $94.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $35.56 / $38.11