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Indiana rates for HCPCS 90680

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.67 / $237.17 / $488.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.60 / $104.67 / $153.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.88 / $205.48 / $308.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.68 / $100.80 / $143.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.56 / $57.56 / $74.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.56 / $57.56 / $71.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.07 / $115.07 / $115.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.36 / $115.07 / $304.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.74 / $116.10 / $174.66