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Alaska rates for HCPCS 91304

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$304.48 / $304.48 / $304.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.20 / $191.91 / $211.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.55 / $188.55 / $188.55
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.73 / $88.73 / $88.73
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $191.92 / $617.98
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.06 / $238.06 / $374.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.05 / $62.05 / $62.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.73 / $218.40 / $514.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.00 / $188.55 / $208.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $171.24 / $202.02