go back

Wisconsin rates for HCPCS 0012A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $102.33
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $89.13
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $245.47 / $245.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11