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Virginia 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
$32.35 / $32.35 / $54.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.35 / $32.35 / $49.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.19 / $31.19 / $31.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.35 / $35.25 / $35.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.78 / $35.18 / $37.61
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.23 / $37.61 / $49.27
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $39.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.72 / $34.71 / $46.32
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.72 / $34.71 / $46.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $37.61 / $39.50