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Missouri 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
$178.54 / $191.92 / $210.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.56 / $191.91 / $191.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.92 / $326.26 / $689.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.72 / $171.72 / $195.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.55 / $188.55 / $193.84
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 / $585.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.54 / $172.52 / $195.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $197.98 / $202.02