go back

Minnesota 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 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $239.88 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $173.78 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $204.17 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $234.42 / $251.19
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $478.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $234.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $162.18 / $323.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $177.83 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $186.21 / $257.04