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Washington 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
$147.91 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $154.88 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.69 / $50.12 / $363.08
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $128.82 / $128.82
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $177.83 / $177.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $112.20 / $123.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $165.96 / $186.21
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $141.25