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Oregon 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
$169.82 / $457.09 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $416.87 / $489.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $204.17 / $239.88
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $239.88
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $181.97 / $309.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $275.42 / $478.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $190.55 / $223.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $234.42 / $575.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $181.97 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $204.17 / $204.17