CPT 91305
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
Sarscov2 Vaccine 30mcg/0.3ml Tris-Sucrose Im Use
Low
$0
Average
$87
Median
$5
High
$934
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +12 other terms | 31 | $0 | $1 | $3 | 505% | — | $0 – $19 |
| 2 | Molina facility · case rate · outpatient · +5 other terms | 27 | $15 | $16 | $7 | 45% | — | $6 – $36 |
| 3 | Anthem fee schedule · outpatient · +7 other terms | 21 | $0 | $1 | $6 | 581% | — | $0 – $35 |
| 4 | UnitedHealthcare facility · case rate · outpatient · +12 other terms | 18 | $10 | $14 | $10 | 72% | — | $6 – $52 |
| 5 | Caresource facility · case rate · outpatient | 15 | $9 | $10 | $2 | 23% | — | $6 – $16 |
| 6 | Optum facility · case rate · outpatient · +5 other terms | 13 | $9 | $11 | $4 | 34% | — | $8 – $18 |
| 7 | Humana fee schedule · outpatient · +7 other terms | 11 | $0 | $10 | $16 | 165% | — | $0 – $36 |
| 8 | Aetna fee schedule · outpatient · +11 other terms | 8 | $18 | $17 | $17 | 98% | — | $0 – $35 |
| 9 | Aetna Better Health facility · case rate · outpatient | 7 | $23 | $22 | $1 | 4% | — | $19 – $23 |
| 10 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $21 | $21 | $1 | 3% | — | $21 – $23 |
| 11 | First Health percent of total billed charges · bothfrom % of charges · +1 other terms | 5 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 12 | Cigna fee schedule · outpatient · +10 other terms | 4 | $2.4k | $1.8k | $1.0k | 58% | — | $1 – $2.4k |
| 13 | Wellmark facility · case rate · outpatient · +1 other terms | 3 | $61 | $54 | $17 | 32% | — | $25 – $68 |
| 14 | Clover facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Medicaid fee schedule · outpatient · +2 other terms | 2 | $2 | $2 | $1 | 40% | — | $1 – $3 |
| 16 | Medicare fee schedule · outpatient · +2 other terms | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Bcbs Ca facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Bcbs Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Beechstreet percent of total billed charges · bothfrom % of charges · +2 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Healthpartners facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Kaiser facility · per diem · inpatient · +4 other terms | 1 | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 22 | Medcost facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Medica facility · case rate · outpatient · +1 other terms | 1 | $1.2k | $1.2k | $711 | 59% | — | $711 – $2.2k |
| 24 | MultiPlan fee schedule · both · +5 other terms | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 25 | Phcs percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting CPT 91305 · Snapshot 20261113T090226Z-3ce6c0b8