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Pennsylvania rates for HCPCS 0034A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage; booster dose

Insurance Carrier
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.18 / $40.07 / $40.07
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.18 / $38.18 / $40.07