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Louisiana 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 / $104.67 / $188.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.67 / $104.67 / $345.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.51 / $112.51 / $168.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.51 / $112.51 / $114.76
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.09 / $90.09 / $90.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.07 / $115.07 / $115.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.07 / $115.07 / $115.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.51 / $116.10 / $123.29