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 Vacc 10mcg/0.3ml Tris-Sucrose Im Use
Low
$39
Average
$244
Median
$108
High
$3.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
58 payers; the 90th percentile is 5.4× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +30 other terms | 540 | $143 | $140 | $69 | 49% | — | $8 – $519 |
| 2 | Cigna fee schedule · outpatient · +21 other terms | 270 | $131 | $229 | $157 | 69% | — | $70 – $738 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +30 other terms | 210 | $154 | $222 | $137 | 62% | — | $1 – $604 |
| 4 | Humana fee schedule · outpatient · +24 other terms | 195 | $88 | $101 | $50 | 49% | — | $16 – $333 |
| 5 | Aetna fee schedule · outpatient · +28 other terms | 148 | $95 | $275 | $785 | 285% | — | $16 – $8.4k |
| 6 | Anthem fee schedule · outpatient · +23 other terms | 94 | $95 | $99 | $41 | 41% | — | $16 – $409 |
| 7 | Molina fee schedule · outpatient · +24 other terms | 65 | $95 | $119 | $67 | 56% | — | $16 – $219 |
| 8 | Caresource fee schedule · outpatient · +13 other terms | 54 | $88 | $88 | $31 | 35% | — | $15 – $149 |
| 9 | WellCare fee schedule · outpatient · +17 other terms | 32 | $94 | $93 | $3 | 4% | — | $88 – $97 |
| 10 | Kaiser fee schedule · outpatient · +12 other terms | 31 | $95 | $104 | $32 | 30% | — | $67 – $223 |
| 11 | Ambetter fee schedule · outpatient · +15 other terms | 26 | $140 | $126 | $67 | 53% | — | $16 – $237 |
| 12 | Medicare fee schedule · outpatient · +7 other terms | 24 | $93 | $74 | $31 | 42% | — | $16 – $93 |
| 13 | Aetna Better Health fee schedule · outpatient · +12 other terms | 23 | $91 | $95 | $6 | 6% | — | $90 – $109 |
| 14 | Devoted facility · fee schedule · outpatient · +12 other terms | 23 | $95 | $815 | $867 | 106% | — | $21 – $2.2k |
| 15 | Healthpartners fee schedule · outpatient · +4 other terms | 19 | $105 | $105 | $3 | 2% | — | $100 – $107 |
| 16 | Bcbs Tx fee schedule · outpatient | 18 | $283 | $291 | $90 | 31% | — | $150 – $466 |
| 17 | Cigna Healthspring fee schedule · outpatient · +5 other terms | 17 | $100 | $96 | $5 | 6% | — | $88 – $100 |
| 18 | Tricare fee schedule · both · +11 other terms | 17 | $88 | $86 | $2 | 3% | — | $83 – $88 |
| 19 | Medica fee schedule · outpatient · +15 other terms | 16 | $158 | $172 | $52 | 30% | — | $31 – $230 |
| 20 | Medical Mutual facility · fee schedule · outpatient · +14 other terms | 16 | $163 | $195 | $83 | 43% | — | $95 – $375 |
| 21 | Optum fee schedule · outpatient · +14 other terms | 16 | $93 | $90 | $6 | 7% | — | $68 – $93 |
| 22 | Carefirst facility · fee schedule · both · +6 other terms | 15 | $95 | $112 | $47 | 42% | — | $95 – $270 |
| 23 | Excellus facility · fee schedule · both · +9 other terms | 15 | $95 | $112 | $47 | 42% | — | $95 – $270 |
| 24 | Highmark fee schedule · outpatient · +11 other terms | 15 | $104 | $103 | $16 | 15% | — | $42 – $109 |
| 25 | Premera facility · fee schedule · both · +6 other terms | 15 | $95 | $112 | $47 | 42% | — | $95 – $270 |
← Hospitals reporting CPT 91319 · Snapshot 20261112T181611Z-3fa9fb76