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Connecticut 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
$191.92 / $191.92 / $191.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $191.92 / $191.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.18 / $279.38 / $575.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.72 / $171.72 / $171.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.55 / $188.55 / $188.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.55 / $188.55 / $188.55
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.55 / $154.55 / $181.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $168.35 / $185.86