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Kentucky 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
$190.55 / $190.55 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $117.49 / $162.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $169.82 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $169.82 / $173.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $309.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $199.53 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $199.53 / $204.17