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New Jersey 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
$104.67 / $104.67 / $123.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.67 / $104.67 / $104.67
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.74 / $94.74 / $94.74
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.62 / $115.62 / $120.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.31 / $115.07 / $119.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.07 / $115.07 / $115.07
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.51 / $8,702.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.50 / $106.59 / $106.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.74 / $116.10 / $125.90