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
$0
Average
$61
Median
$29
High
$289
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 134.7× 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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31 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 | $95 | $95 | — | — | — | $95 – $95 |
| 2 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 3 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 4 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 5 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 6 | Geisinger Bloomsburg Hospital Bloomsburg, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Geisinger Jersey Shore Hospital Jersey Shore, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 13 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA fee schedule · both | 2 | $91 | $91 | $4 | 4% | — | $88 – $95 |
| 14 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 16 | IOM Health System LP Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 17 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · other · outpatient | 1 | $262 | $262 | — | — | — | $262 – $262 |
| 19 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 20 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $289 | $289 | — | — | — | $289 – $289 |
| 21 | NYU Langone Mineola, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 22 | NYU Langone Brooklyn, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 23 | NYU Langone New York, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 24 | NYU Langone Hospital?Suffolk Patchogue, NY case rate · outpatient | 15 | $29 | $29 | — | — | — | $29 – $29 |
| 25 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
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