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New Mexico 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
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $112.20 / $141.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $75.86 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $77.62 / $229.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $123.03 / $123.03