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Hawaii 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

Professionalmedian $191 · 10th–90th $182–$2040%50%10th90th$191$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $194.98
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $204.17 / $251.19