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
COVID VAC 2025-26 (6MO-11YR)(MODERNA) (PF) 25 MCG/0.25 ML IM SYRINGE
Low
$0
Average
$189
Median
$147
High
$751
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
269 hospitals; the 90th percentile is 2.5× 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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432 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 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $129 | $135 | $7 | 5% | 2–20 | $129 – $144 |
| 2 | Mishawaka Medical Center Mishawaka, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $294 | $294 | — | — | 2–20 | $294 – $294 |
| 3 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 2 | $129 | $135 | $7 | 5% | 2–20 | $129 – $144 |
| 4 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $194 | $194 | — | — | 1–10 | $194 – $194 |
| 5 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $287 | $287 | $23 | 8% | — | $264 – $310 |
| 7 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $663 | $663 | $397 | 60% | — | $266 – $1.1k |
| 8 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $642 | $642 | $385 | 60% | — | $257 – $1.0k |
| 9 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $164 | $164 | $20 | 12% | — | $144 – $185 |
| 10 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 2 | $147 | $142 | $7 | 5% | — | $131 – $147 |
| 11 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $93 | $87 | $14 | 16% | — | $68 – $101 |
| 12 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $84 | $78 | $24 | 31% | — | $40 – $102 |
| 13 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $99 | $99 | $0 | 0% | — | $98 – $99 |
| 14 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 5 | $87 | $85 | $11 | 13% | — | $70 – $99 |
| 15 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 16 | Ascension Calumet Hospital, Inc. Chilton, WI other · outpatient | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 17 | Ascension NE Wisconsin, Inc. Appleton, WI other · outpatient | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 18 | Ascension NE Wisconsin, Inc. Oshkosh, WI other · outpatient | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 19 | Ascension SE Wisconsin Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $243 | $281 | $72 | 26% | — | $219 – $382 |
| 20 | Ascension SE Wisconsin Hospital, Inc. Franklin, WI other · outpatient | 3 | $243 | $281 | $72 | 26% | — | $219 – $382 |
| 21 | Ascension SE Wisconsin Hospital, Inc. Brookfield, WI other · outpatient | 3 | $243 | $281 | $72 | 26% | — | $219 – $382 |
| 22 | Ascension St. Francis Hospital, Inc. Milwaukee, WI other · outpatient | 3 | $243 | $281 | $72 | 26% | — | $219 – $382 |
| 23 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 10 | $146 | $144 | $5 | 3% | — | $134 – $146 |
| 24 | Aspirus Divine Savior Hospital Portage, WI fee schedule · both | 3 | $131 | $131 | — | — | — | $131 – $131 |
| 25 | Aspirus Medford Hospital Medford, WI fee schedule · both | 1 | $131 | $131 | — | — | — | $131 – $131 |
← Payers reporting CPT 91321 · Snapshot 20261111T120946Z-9134e7f7