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New York 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
$26.92 / $32.36 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $32.36 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $32.36 / $32.36
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $30.90
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $35.48 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $169.82
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $69.18
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $35.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $50,118.72 / $75,857.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $35.48 / $47.86
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $33.11 / $34.67
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $33.11 / $39.81