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COVID-19 Vaccine Product

South Dakota rates for HCPCS 91304

Covers a dose of COVID-19 vaccine — the vaccine material itself, kept separate from the charge for the visit and for giving the injection. Each brand and formulation of COVID-19 vaccine is listed on its own.

Facilitymedian $191 · 10th–90th $191$1910%50%$191Professionalmedian $191 · 10th–90th $170$2450%50%10th90th$191$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$245.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$275.42
Typical High
$524.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$177.83
Typical High
$190.55
Midlands
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$186.21
Typical High
$213.80
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55