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COVID-19 Vaccine Product

Wisconsin 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.

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $182$4680%20%40%10th90th$191Professionalmedian $191 · 10th–90th $174$3470%20%10th90th$191$100.0$200.0$500.0$1.0K

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
$269.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$416.87
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$218.78
Typical High
$537.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$194.98
Typical High
$354.81
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$426.58
Medica
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$162.18
Typical High
$354.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$169.82
Typical High
$257.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$190.55
Network Health
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$426.58
Quartz
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$407.38
Typical High
$630.96
Quartz
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$575.44
Typical High
$602.56
Quartz
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$288.40
Security Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$190.55
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$190.55
Typical High
$275.42