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Michigan 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
$104.71 / $181.97 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $151.36 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $141.25 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $309.03 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $147.91 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $177.83 / $537.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $199.53 / $295.12
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $177.83 / $186.21