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New Hampshire 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 / $36.31 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $32.36
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $66.07 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $32.36 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $53.70 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $31.62 / $38.02