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Louisiana 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 / $58.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.35 / $32.35 / $32.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.71 / $34.71 / $52.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.71 / $34.71 / $35.40
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.80 / $24.80 / $24.80
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.10 / $35.56 / $37.76