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 SARSCOV2 VAC 3MCG TRS-SUC IM
Low
$38
Average
$101
Median
$74
High
$585
Each hospital's average Medica rate, under the methodology and billing class chosen below.
51 hospitals; the 90th percentile is 3.9× 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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78 hospital rates
iThe hospitals that file a Medica 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 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $73 | $73 | $21 | 29% | 1–10 | $52 – $94 |
| 2 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $31 | $38 | $18 | 47% | — | $22 – $66 |
| 3 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $31 | $38 | $18 | 47% | — | $22 – $66 |
| 4 | Amery Hospital Amery, WI facility · case rate · both | 1 | $379 | $379 | — | — | — | $379 – $379 |
| 5 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 6 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 3 | $101 | $146 | $121 | 83% | — | $31 – $350 |
| 7 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $350 | $350 | — | — | — | $350 – $350 |
| 8 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $197 | $197 | $13 | 6% | — | $185 – $210 |
| 9 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 10 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 11 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 12 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $39 | $39 | $5 | 12% | — | $34 – $44 |
| 13 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | $5 | 12% | — | $34 – $44 |
| 14 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $39 | $39 | $5 | 12% | — | $34 – $44 |
| 15 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | $5 | 12% | — | $34 – $44 |
| 16 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 17 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 18 | Curators of the University of Missouri Jefferson City, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 19 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 8 | $129 | $110 | $32 | 30% | — | $66 – $142 |
| 20 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 7 | $36 | $34 | $7 | 21% | — | $21 – $41 |
| 21 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 7 | $39 | $36 | $8 | 23% | — | $21 – $43 |
| 22 | Fairview Health Services Edina, MN fee schedule · both | 8 | $129 | $110 | $32 | 30% | — | $66 – $142 |
| 23 | Fairview Health Services Edina, MN fee schedule · outpatient | 7 | $155 | $139 | $35 | 26% | — | $81 – $172 |
| 24 | Fairview Health Services Minneapolis, MN fee schedule · both | 8 | $129 | $110 | $32 | 30% | — | $66 – $142 |
| 25 | Fairview Health Services Minneapolis, MN fee schedule · outpatient | 7 | $150 | $135 | $33 | 25% | — | $81 – $166 |
← Payers reporting CPT 91318 · Snapshot 20261112T181611Z-3fa9fb76