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
PR NOVAVAX COVID-19 VACCINE, 5 MCG/0.5ML IM
Low
$21
Average
$92
Median
$49
High
$257
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
25 hospitals; the 90th percentile is 10.3× 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.
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26 hospital rates
iThe hospitals that file a Amerihealth Caritas rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 2 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 3 | Central Louisiana Surgical Hospital Alexandria, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 4 | Coushatta Health Care Center Coushatta, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 5 | Highland Medical Center - Shreveport Shreveport, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 6 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $257 | $257 | — | — | — | $257 – $257 |
| 7 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $257 | $257 | — | — | — | $257 – $257 |
| 8 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 9 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Ochsner Lake Area Hospital Lake Charles, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 11 | Ochsner St. Patrick Hospital Lake Charles, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 12 | Rex Hospital, Inc. Holly Springs, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 13 | SOUTHERN REGIONAL MEDICAL CORPORATION Houma, LA other · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 14 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 15 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 16 | Southern Baptist Hospital of Florida, INC Fleming Island, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 18 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 19 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 20 | St. Frances Cabrini Hospital Alexandria, LA fee schedule · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 21 | The New London Hospital Association, Inc. London, NH professional · fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 22 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $257 | $257 | — | — | — | $257 – $257 |
| 23 | Uniontown Hospital Uniontown, PA facility · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 24 | University of Florida Health Gainesville, FL facility · case rate · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 25 | Weirton Medical Center Inc Weirton, WV facility · fee schedule · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
← Payers reporting CPT 91304 · Snapshot 20261113T090226Z-3ce6c0b8