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South Dakota rates for HCPCS 90680

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

Facilitymedian $102 · 10th–90th $102$2140%50%90th$102Professionalmedian $115 · 10th–90th $95$1380%20%10th90th$115$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $120.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $109.65
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $123.03
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33