go back

Utah rates for HCPCS 91304

Sarscov2 Vacc Saponin-Bsd Adjt 5mcg/0.5ml Im Use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.92 / $191.92 / $191.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.92 / $191.92 / $191.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.55 / $188.55 / $188.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.09 / $211.83 / $211.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.93 / $190.24 / $202.02