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Illinois 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

Facilitymedian $214 · 10th–90th $191–$3800%20%10th90th$214Professionalmedian $191 · 10th–90th $186–$2140%50%10th90th$191$0.1$0.2$1.0$5.0$20.0$100.0$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
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $204.17