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Pennsylvania 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
$89.13 / $147.91 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $151.36 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $125.89 / $147.91
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $186.21 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $169.82 / $229.09
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $151.36 / $251.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $151.36 / $371.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $181.97 / $234.42