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
$9
Median
$0
High
$64
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63 hospital rates
iThe hospitals that file a Anthem 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 4 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 4 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI other · outpatient | 4 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 5 | Ascension SE Wisconsin Hospital, Inc. Franklin, WI other · outpatient | 4 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 6 | Ascension SE Wisconsin Hospital, Inc. Brookfield, WI other · outpatient | 4 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 7 | Ascension St. Francis Hospital, Inc. Milwaukee, WI other · outpatient | 4 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 8 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 10 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 11 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 12 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 13 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 14 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 15 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 17 | Columbia St. Mary's Hospital Milwaukee, Inc. Milwaukee, WI other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Columbia St. Mary's Hospital Ozaukee, Inc. Mequon, WI other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 20 | Endo Surgery Center Carmel, IN fee schedule · outpatient | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 22 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 23 | Greenfield Area Medical Center Greenfield, OH facility · fee schedule · outpatient | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 25 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
← Payers reporting CPT 91305 · Snapshot 20261113T090226Z-3ce6c0b8