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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
$31.42 / $36.50 / $49.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.66 / $32.35 / $59.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.18 / $68.78 / $130.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.90 / $29.90 / $31.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.78 / $35.25 / $35.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.35 / $33.86 / $48.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.85 / $33.36 / $53.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.43 / $47.43 / $47.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $37.61 / $40.06