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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
$191.92 / $191.92 / $211.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.91 / $191.92 / $191.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.62 / $170.44 / $383.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.96 / $171.72 / $171.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.92 / $211.11 / $307.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $211.11 / $295.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.53 / $188.55 / $188.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.55 / $215.95 / $215.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $198.65 / $202.02