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Montana rates for HCPCS 90648

Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $16.60 / $52.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $46,773.51 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $35.48
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $38.90 / $44.67
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $44.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $61.66
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $43.65 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.85 / $16.60