CPT 91304
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC Sarscov2 Vacc Saponin-Bsd Adjt 5mcg/0.5ml Im Us
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$197
Median
$197
High
$916
Showing only prices reported under the other methodology. Choose another in the filter below to change the chart. 85 hospitals; the 90th percentile is 36347.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
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Reflects a payer-specific billing methodology not covered by the standard categories.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Tufts Medical Center BOSTON, MA | $735 | $735 | — | — | 1–10 | $735 – $735 |
| 2 | St. Mary's Health, Inc. Evansville, IN | $363 | $363 | — | — | — | $363 – $363 |
| 3 | Columbia St. Mary's Hospital Ozaukee, Inc. Mequon, WI | $444 | $444 | — | — | — | $444 – $444 |
| 4 | Henry Ford Health Novi, MI | $0 | $0 | — | — | — | $0 – $0 |
| 5 | St. Vincent's Medical Center-Clay County, Inc. Middleburg, FL | $197 | $197 | — | — | — | $197 – $197 |
| 6 | St. Luke's-St. Vincent's Healthcare, Inc. Jacksonville, FL | $197 | $197 | — | — | — | $197 – $197 |
| 7 | University Medical Center of Southern Nevada Las Vegas, NV | $162 | $162 | — | — | — | $162 – $162 |
| 8 | Saint Elizabeth’s Hospital of Wabasha Inc Wabasha, MN | $526 | $526 | — | — | — | $526 – $526 |
| 9 | Endo Surgery Center Carmel, IN | $363 | $363 | — | — | — | $363 – $363 |
| 10 | Naab Road Surgery Center Indianapolis, IN | $363 | $363 | — | — | — | $363 – $363 |
Ask Claude or any MCP client for CPT 91304 pricing at a specific hospital — see how to connect.