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
$0
Average
$104
Median
$29
High
$647
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 12.0× 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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23 hospital rates
iThe hospitals that file a Medicaid 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 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 2 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 3 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 4 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 5 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA fee schedule · both | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 6 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 9 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · other · outpatient | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 11 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 12 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $647 | $647 | — | — | — | $647 – $647 |
| 13 | NYU Langone Mineola, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 14 | NYU Langone Brooklyn, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 15 | NYU Langone New York, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 16 | NYU Langone Hospital?Suffolk Patchogue, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 17 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 18 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $647 | $647 | — | — | — | $647 – $647 |
| 19 | UMass Memorial Health - Harrington Hospital, Inc. 2nd Floor Webster, MA fee schedule · both | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 20 | UMass Memorial Health - Harrington Hospital, Inc. 2nd Floor Webster, MA percent of total billed charges · bothfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | UMass Memorial Medical Center MA 01605; 157 Union Street Marlborough, MA fee schedule · both | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 22 | UMass Memorial Medical Center MA 01605; 157 Union Street Marlborough, MA percent of total billed charges · bothfrom % of charges | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Warsaw Health System LLC Warsaw, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
← Payers reporting CPT 91318 · Snapshot 20261112T181611Z-3fa9fb76