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West 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
$31.42 / $32.35 / $36.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.35 / $32.35 / $36.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.35 / $21.02 / $30.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.18 / $47.18 / $47.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.25 / $35.25 / $130.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.47 / $37.61 / $40.18