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Utah rates for HCPCS 90680

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

Facilitymedian $105 · 10th–90th $87–$1100%50%10th90th$105Professionalmedian $105 · 10th–90th $91–$1700%20%10th90th$105$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
$87.10 / $104.71 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $89.13 / $117.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $104.71 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $123.03