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Michigan 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 / $46.77 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $32.36 / $60.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $30.20 / $39.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $66.07 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $31.62 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $40.74 / $107.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $39.81 / $57.54
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $38.02 / $38.90