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
$137
Average
$204
Median
$182
High
$452
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
7 hospitals; the 90th percentile is 2.2× 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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7 hospital rates
iThe hospitals that file a Excellus 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 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 2 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $192 | $192 | — | — | — | $192 – $192 |
| 3 | Massena Hospital Inc Massena, NY facility · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 4 | Rochester General Hospital Rochester, NY facility · fee schedule · outpatient | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 5 | Samaritan Medical Center Watertown, NY facility · case rate · outpatient | 2 | $452 | $452 | $290 | 64% | — | $162 – $741 |
| 6 | The Unity Hospital of Rochester Rochester, NY facility · fee schedule · outpatient | 2 | $137 | $137 | — | — | — | $137 – $137 |
| 7 | University of Vermont Medical Center Inc Colchester, VT professional · fee schedule · both | 3 | $177 | $182 | $7 | 4% | — | $177 – $192 |
← Payers reporting CPT 91304 · Snapshot 20261113T090226Z-3ce6c0b8