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
$0
Average
$172
Median
$192
High
$214
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
96 hospitals; the 90th percentile is 1.2× 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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97 hospital rates
iThe hospitals that file a WellCare 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 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $206 | $206 | $5 | 2% | — | $202 – $211 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $196 | $196 | — | — | — | $196 – $196 |
| 3 | Aiken Regional Medical Centers North Augusta, SC fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 4 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 5 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $166 | $166 | — | — | — | $166 – $166 |
| 6 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $196 | $196 | — | — | — | $196 – $196 |
| 7 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 8 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 9 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 10 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 11 | Columbus Regional Healthcare System, Inc Whiteville, NC fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 12 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 13 | Deaconess Illinois Crossroads Inc Mount Vernon, IL facility · case rate · outpatient | 2 | $162 | $162 | — | — | — | $162 – $162 |
| 14 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL facility · case rate · outpatient | 2 | $164 | $164 | $2 | 1% | — | $162 – $166 |
| 15 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $196 | $196 | — | — | — | $196 – $196 |
| 16 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 17 | Floyd Healthcare Management Inc Rome, GA case rate · outpatient | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 18 | Froedtert Bluemound Rehabilitation Hospital Wauwatosa, WI case rate · outpatient | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 19 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI case rate · outpatient | 1 | $165 | $165 | — | — | — | $165 – $165 |
| 20 | Gouverneur Hospital Gouverneur, NY facility · fee schedule · outpatient | 2 | $192 | $192 | — | — | — | $192 – $192 |
| 21 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 22 | HMH HOSPITALS CORPORATION Point Pleasant, NJ facility · percent of total billed charges · bothfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 24 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 25 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
← Payers reporting CPT 91304 · Snapshot 20261113T090226Z-3ce6c0b8