COVID-19 vaccine, recombinant nanoparticle, 5 mcg dose

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR NOVAVAX COVID-19 VACCINE, 5 MCG/0.5ML IM

Payers reporting CPT 91304

Payer pricing summary

Low

$77

Average

$189

Median

$175

High

$376

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +23 other terms	546	$267	$267	$148	56%	—	$0 – $1.0k
2	Cigna fee schedule · outpatient · +18 other terms	264	$238	$433	$351	81%	—	$0 – $2.4k
3	Humana fee schedule · outpatient · +19 other terms	191	$157	$178	$95	53%	—	$0 – $562
4	Aetna fee schedule · outpatient · +22 other terms	141	$162	$435	$1.0k	235%	—	$0 – $8.4k
5	Blue Cross Blue Shield fee schedule · outpatient · +20 other terms	131	$165	$199	$224	112%	—	$0 – $1.1k
6	Anthem fee schedule · outpatient · +21 other terms	109	$178	$201	$139	70%	—	$0 – $1.1k
7	Caresource fee schedule · outpatient · +7 other terms	53	$177	$199	$55	28%	—	$1 – $288
8	Molina fee schedule · outpatient · +17 other terms	51	$212	$229	$151	66%	—	$0 – $399
9	Kaiser fee schedule · outpatient · +8 other terms	31	$158	$107	$88	82%	—	$0 – $372
10	WellCare fee schedule · outpatient · +10 other terms	26	$166	$173	$14	8%	—	$162 – $196
11	Aetna Better Health fee schedule · outpatient · +6 other terms	22	$162	$173	$19	11%	—	$153 – $200
12	Devoted fee schedule · outpatient · +2 other terms	21	$162	$162	$6	4%	—	$158 – $188
13	Healthpartners fee schedule · outpatient · +4 other terms	18	$193	$193	$4	2%	—	$189 – $197
14	Medicare fee schedule · outpatient · +6 other terms	18	$158	$172	$15	9%	—	$158 – $188
15	Medical Mutual facility · fee schedule · outpatient · +4 other terms	17	$352	$380	$147	39%	—	$192 – $689
16	Ambetter fee schedule · outpatient · +6 other terms	15	$317	$315	$85	27%	—	$68 – $400
17	Optum facility · case rate · outpatient · +8 other terms	14	$9	$31	$52	167%	—	$8 – $165
18	Wellmark fee schedule · both · +7 other terms	14	$162	$161	$5	3%	—	$133 – $167
19	Cigna Healthspring fee schedule · outpatient · +2 other terms	12	$170	$170	—	—	—	$170 – $170
20	Bcbs Nj fee schedule · outpatient · +3 other terms	11	$169	$170	$15	9%	—	$162 – $199
21	Highmark fee schedule · outpatient · +5 other terms	11	$188	$186	$43	23%	—	$42 – $217
22	Oscar facility · fee schedule · outpatient · +8 other terms	11	$200	$198	$4	2%	—	$192 – $200
23	Medica fee schedule · outpatient · +7 other terms	10	$301	$303	$76	25%	—	$182 – $388
24	Regence fee schedule · outpatient · +9 other terms	10	$242	$242	$85	35%	—	$162 – $440
25	Clover fee schedule · outpatient · +4 other terms	9	$165	$169	$12	7%	—	$162 – $192

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