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Pennsylvania rates for HCPCS M0201

Administration Of Pneumococcal Influenza Hepatis B And/Or Covid-19 Vaccine Inside A Patients Home; Reported Only Once Per Individual Home Per Date Of Service When Such Vaccine Administration(S) Are Performed At The Patients Home (Desc Rvsd 1/1/2024)

Insurance Carrier
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.77 / $42.31 / $42.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.89 / $31.89 / $31.89
Johns Hopkins Employer Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.88 / $45.88 / $45.88
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.89 / $31.89 / $31.89
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.19 / $35.56 / $35.56
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.19 / $34.19 / $35.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.22 / $38.54 / $66.55