Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SOLN [79990]
Arlington, TX
See all hospitals reporting CPT 90680 →Price type
AMH Cath Labs LLC’s median price of $108 is 22% below the median hospital's median price ($139), higher than 30% of the 1,554 hospitals reporting CPT 90680. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $15 | $15 | — | — | — | $15 – $15 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $16 | $16 | — | — | — | $16 – $16 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $16 | $16 | — | — | — | $16 – $16 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $17 | $17 | — | — | — | $17 – $17 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $59 | $59 | — | — | — | $59 – $59 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $70 | $70 | — | — | — | $70 – $70 |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $79 | $79 | — | — | — | $79 – $79 |
| 9 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $89 | $89 | — | — | — | $89 – $89 |
| 10 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $94 | $94 | — | — | — | $94 – $94 |
| 11 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $94 | $94 | — | — | — | $94 – $94 |
| 12 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 13 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $119 | $119 | — | — | — | $119 – $119 |
| 14 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $119 | $119 | — | — | — | $119 – $119 |
| 15 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $120 | $120 | — | — | — | $120 – $120 |
| 16 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $120 | $120 | — | — | — | $120 – $120 |
| 17 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 18 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $149 | $149 | — | — | — | $149 – $149 |
| 19 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $149 | $149 | — | — | — | $149 – $149 |
| 20 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $161 | $161 | — | — | — | $161 – $161 |
| 21 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $161 | $161 | — | — | — | $161 – $161 |
| 22 | Blue Cross Blue Shield hmo fee schedule · outpatient | $203 | $203 | — | — | — | $203 – $203 |
| 23 | Blue Cross Blue Shield exchange fee schedule · outpatient | $208 | $208 | — | — | — | $208 – $208 |
| 24 | Blue Cross Blue Shield ppo fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $921 | $921 | — | — | — | $921 – $921 |
Last updated: Apr 21, 2026
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