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Idaho 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
Professional
Modifier
Low / Median / High Price
$191.91 / $191.92 / $211.11
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.92 / $203.44 / $274.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $239.90 / $239.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.16 / $222.20 / $296.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.22 / $222.22 / $227.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.24 / $202.02 / $202.02