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 VAC 5MCG/0.5ML IM
Boulder, CO
See all hospitals reporting CPT 91304 →Price type
Boulder Community Health’s median price of $198 is 2% above the median hospital's median price ($193), higher than 54% of the 1,155 hospitals reporting CPT 91304. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 17 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Cigna commercial facility · fee schedule · outpatient | $159 | $159 | — | — | — | $159 – $159 |
| 2 | Aetna medicare advantage professional · fee schedule · both | $162 | $162 | — | — | — | $162 – $162 |
| 3 | UnitedHealthcare commercial professional · fee schedule · both | $162 | $162 | — | — | — | $162 – $162 |
| 4 | Cigna commercial professional · fee schedule · both | $189 | $189 | — | — | — | $189 – $189 |
| 5 | Aetna medicare advantage facility · case rate · outpatient | $192 | $192 | — | — | — | $192 – $192 |
| 6 | Anthem medicare advantage facility · case rate · outpatient | $192 | $192 | — | — | — | $192 – $192 |
| 7 | Humana medicare advantage professional · fee schedule · both | $192 | $192 | — | — | — | $192 – $192 |
| 8 | UnitedHealthcare medicare advantage professional · fee schedule · both | $192 | $192 | — | — | — | $192 – $192 |
| 9 | Humana medicare advantage facility · case rate · outpatient | $196 | $196 | — | — | — | $196 – $196 |
| 10 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $196 | $196 | — | — | — | $196 – $196 |
| 11 | Kaiser medicare advantage facility · case rate · outpatient | $197 | $197 | $1 | 0% | — | $196 – $198 |
| 12 | Devoted medicare advantage facility · case rate · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 13 | Anthem commercial professional · fee schedule · both | $202 | $202 | — | — | — | $202 – $202 |
| 14 | Anthem managed care professional · fee schedule · both | $202 | $202 | — | — | — | $202 – $202 |
| 15 | Aetna commercial professional · fee schedule · both | $233 | $233 | $71 | 31% | — | $162 – $304 |
| 16 | Kaiser commercial facility · case rate · outpatient | $419 | $419 | $51 | 12% | — | $368 – $469 |
| 17 | Kaiser managed care facility · case rate · outpatient | $465 | $465 | — | — | — | $465 – $465 |
Last updated: Sep 16, 2026
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