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Kansas 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 / $230.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.91 / $191.92 / $191.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.79 / $181.00 / $185.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.02 / $202.02 / $202.02
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.63 / $191.92 / $286.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.04 / $172.52 / $190.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.80 / $197.98 / $202.02