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North Dakota 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
$30.90 / $32.36 / $32.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $32.36 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $29.51 / $37.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $35.48 / $93.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $33.88 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $34.67 / $38.02