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  4. /91304
  5. /Case rate
CPT 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

Reported by 39 hospitals in the network under the case rate methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

National pricing summary

Low

$0

Average

$324

Median

$170

High

$4.7k

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1The Finley HospitalDubuque, IA$170$170$7—$153$187
2Northwest Iowa Hospital CorporationSioux City, IA$167$167$2—$153$170
3St Luke's Methodist HospitalCedar Rapids, IA$167$167$2—$153$170
4Trinity Medical CenterRock Island, IL$165$174$27—$152$258
5Trinity Medical CenterBettendorf, IA$170$180$32—$153$258
6Unity HealthcareMuscatine, IA$167$178$31—$153$258
7Trinity Regional Medical CenterFort Dodge, IA$167$167$2—$153$170
8Meriter Hospital, IncMadison, WI$162$162——$162$162
9Central Iowa Hospital CorporationDes Moines, IA$167$167$2—$153$170
10Central Iowa Hospital CorporationDes Moines, IA$167$167$2—$153$170
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