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Hawaii rates for HCPCS 90681

Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.26 / $149.83 / $160.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.66 / $164.66 / $164.66
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.63 / $158.63 / $158.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.61 / $176.27 / $220.53
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.36 / $145.68 / $154.37