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Virginia 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
$191.92 / $191.92 / $470.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.91 / $191.92 / $211.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.92 / $404.95 / $652.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.72 / $171.72 / $171.72
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.72 / $230.69 / $348.13
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 / $188.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.13 / $202.02 / $230.30
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.04 / $170.04 / $292.29
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.18 / $184.21 / $247.81
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.18 / $184.21 / $247.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.35 / $202.02 / $212.12