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Michigan rates for HCPCS 90649

4vhpv Vaccine 3 Dose Schedule For Im Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.24 / $163.24 / $163.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.24 / $163.24 / $179.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.33 / $350.08 / $662.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.16 / $152.16 / $160.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.71 / $179.39 / $182.45
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.24 / $192.05 / $192.05
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.24 / $192.05 / $230.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.98 / $192.05 / $204.58