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Louisiana rates for HCPCS 90681

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.83 / $149.83 / $149.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.83 / $149.83 / $149.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.46 / $167.46 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.46 / $167.46 / $170.81
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.73 / $117.73 / $117.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.66 / $164.66 / $164.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.66 / $164.66 / $164.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.02 / $166.13 / $176.42