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Nebraska 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
$79.78 / $104.67 / $145.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.18 / $120.80 / $166.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.69 / $342.44 / $696.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.54 / $96.39 / $128.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.00 / $115.07 / $120.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.98 / $115.00 / $431.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.82 / $108.70 / $118.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.80 / $111.56 / $134.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.33 / $111.56 / $147.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.74 / $113.01 / $123.14