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
$33
Median
$4
High
$783
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47 hospital rates
iThe hospitals that file a Aetna 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 | Ascension Via Christi Rehabilitation Hospital, Inc. Wichita, KS fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 2 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 3 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 5 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 6 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 9 | Garnet Health Medical Center Middletown, NY facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Garnet Health Medical Center Catskills Harris, NY facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $1 | 27% | — | $4 – $7 |
| 13 | HMH Carrier Behavioral Health Inc Belle Mead, NJ facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | $0 | 25% | — | $0 – $0 |
| 14 | HMH HOSPITALS CORPORATION Point Pleasant, NJ facility · percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | HMH HOSPITALS CORPORATION Point Pleasant, NJ facility · percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 18 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 19 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $21 | $21 | $2 | 9% | — | $19 – $23 |
| 20 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 21 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | NORTHERN MAINE MEDICAL CENTER FORT KENT, ME percent of total billed charges · outpatientfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | NewYork-Presbyterian Columbia University Irving Medical Center|NewYork-Presbyterian Weill Cornell Medical Center|NewYork-Presbyterian Brooklyn Methodist Hospital Brooklyn, NY percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | NewYork-Presbyterian Hudson Valley Hospital Manor, NY percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | NewYork-Presbyterian Queens Flushing, NY percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting CPT 91305 · Snapshot 20261113T090226Z-3ce6c0b8