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Ohio 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
$28.18 / $41.69 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $32.36 / $56.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $26.92 / $30.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $67.61 / $204.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $33.88 / $56.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $21.38 / $22.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84
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 / $52.48
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $35.48 / $35.48
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $52.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $47.86 / $66.07
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $38.02 / $77.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $36.31 / $38.02