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Montana rates for HCPCS 90739

Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.64 / $80.64 / $80.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.60 / $177.56 / $343.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.68 / $202.68 / $202.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.44 / $174.44 / $202.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.68 / $202.68 / $202.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.44 / $192.63 / $251.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.00 / $176.00 / $186.90