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North Carolina 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
$186.18 / $191.92 / $218.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.91 / $191.92 / $201.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.54 / $161.54 / $161.54
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 / $202.02
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.04 / $191.92 / $228.38
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.20 / $109.20 / $109.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $178.45 / $202.02
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.22 / $208.22 / $340.08