Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML INTRAMUSC SYRG [89581]
Arlington, TX
See all hospitals reporting CPT 90633 →Price type
AMH Cath Labs LLC’s median price of $87 is 34% above the median hospital's median price ($65), higher than 66% of the 1,686 hospitals reporting CPT 90633. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $14 | $14 | — | — | — | $14 – $14 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $14 | $14 | — | — | — | $14 – $14 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $72 | $72 | — | — | — | $72 – $72 |
| 9 | Blue Cross Blue Shield hmo fee schedule · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 10 | Blue Cross Blue Shield exchange fee schedule · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 11 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $81 | $81 | — | — | — | $81 – $81 |
| 12 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $86 | $86 | — | — | — | $86 – $86 |
| 13 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $86 | $86 | — | — | — | $86 – $86 |
| 14 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $87 | $87 | — | — | — | $87 – $87 |
| 15 | Blue Cross Blue Shield ppo fee schedule · outpatient | $87 | $87 | — | — | — | $87 – $87 |
| 16 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 17 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 18 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $110 | $110 | — | — | — | $110 – $110 |
| 19 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $110 | $110 | — | — | — | $110 – $110 |
| 20 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $117 | $117 | — | — | — | $117 – $117 |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $136 | $136 | — | — | — | $136 – $136 |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $136 | $136 | — | — | — | $136 – $136 |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $356 | $356 | — | — | — | $356 – $356 |
Last updated: Apr 21, 2026
See Hepatitis A vaccine, children and teens, two-dose series pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.