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Minnesota rates for HCPCS 0022A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5mL dosage; second dose

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $134.90 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $43.65 / $51.29
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $128.82 / $251.19
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $56.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $46.77 / $46.77