CPT 0121A

COVID-19 bivalent vaccine administration, single dose

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Imm Admn Sarscov2 Vaccine Bvl 30 Mcg/0.3 Ml Tris-Suc Single Dose

Payer pricing summary

Low

$13

Average

$670

Median

$56

High

$17.5k

Payer rate distribution

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Filter by billing class

#
1	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	76	$125	$129	$52	40%	—	$31 – $248
2	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$43	$35	$9	27%	—	$10 – $46
3	Molina facility · case rate · outpatient · +3 other terms	26	$22	$25	$10	42%	—	$11 – $57
4	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$12	$13	$4	32%	—	$6 – $25
5	UnitedHealthcare fee schedule · outpatient · +7 other terms	23	$44	$40	$20	49%	—	$10 – $76
6	Anthem fee schedule · outpatient · +6 other terms	22	$16	$17	$8	45%	—	$16 – $72
7	MultiPlan fee schedule · inpatient · +8 other terms	18	$64	$66	$5	8%	—	$58 – $75
8	Medica fee schedule · outpatient · +1 other terms	17	$55	$59	$13	22%	—	$25 – $76
9	Humana fee schedule · outpatient · +5 other terms	16	$53	$66	$32	49%	—	$13 – $103
10	Caresource facility · case rate · outpatient · +1 other terms	15	$16	$17	$4	23%	—	$11 – $27
11	Ambetter facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	13	$52	$52	—	—	—	$52 – $52
12	Optum facility · case rate · outpatient · +2 other terms	13	$15	$18	$5	27%	—	$13 – $26
13	Wellmark fee schedule · both · +3 other terms	13	$40	$40	—	—	—	$40 – $40
14	Phcs fee schedule · inpatient · +3 other terms	10	$52	$59	$9	15%	—	$52 – $71
15	Aetna Better Health facility · case rate · outpatient · +3 other terms	6	$33	$33	—	—	—	$33 – $33
16	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	6	$30	$30	—	—	—	$30 – $30
17	Aetna fee schedule · outpatient · +11 other terms	5	$54	$52	$15	29%	—	$22 – $72
18	Regence fee schedule · outpatient · +1 other terms	5	$69	$69	$11	16%	—	$53 – $82
19	Medicaid facility · case rate · outpatient	2	$27	$27	—	—	—	$27 – $27
20	Sanford Health Plan fee schedule · inpatient · +1 other terms	2	$67	$67	—	—	—	$67 – $67
21	Bcbs Vt percent of total billed charges · outpatientfrom % of charges	1	$42	$42	—	—	—	$42 – $42
22	Carefirst facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$49	$49	—	—	—	$49 – $49
23	Cigna fee schedule · both · +8 other terms	1	$48	$48	$4	9%	—	$44 – $52
24	Devoted facility · percent of total billed charges · inpatientfrom % of charges · +3 other terms	1	$97	$97	—	—	—	$97 – $97
25	First Health fee schedule · outpatient · +4 other terms	1	$122	$122	—	—	—	$122 – $122

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