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Hawaii rates for HCPCS 90680

Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $127.08 / $358.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.07 / $115.07 / $115.07
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.83 / $110.83 / $110.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.50 / $123.14 / $154.11
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.55 / $97.85 / $103.76