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

Anthem pricing summary

Low

$11

Average

$28

Median

$17

High

$93

Anthem rate distribution

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58 hospital rates

#		Plans
1	AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
2	Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient	8	$16	$16	—	—	—	$16 – $16
3	Boulder Community Health Lafayette, CO facility · percent of total billed charges · inpatientfrom % of charges	1	$139	$139	—	—	—	$139 – $139
4	Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges	2	$84	$87	$25	28%	—	$60 – $144
5	CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
6	CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient	1	$26	$26	—	—	—	$26 – $26
7	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient	1	$16	$16	—	—	—	$16 – $16
8	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient	1	$16	$16	—	—	—	$16 – $16
9	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient	1	$17	$17	—	—	—	$17 – $17
10	COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient	1	$59	$59	—	—	—	$59 – $59
11	Carmel AmbSurg Carmel, IN fee schedule · outpatient	8	$16	$16	—	—	—	$16 – $16
12	Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges	3	$59	$60	$2	3%	—	$59 – $62
13	Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges	3	$62	$62	—	—	—	$62 – $62
14	Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
15	Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges	2	$56	$56	$1	2%	—	$54 – $57
16	Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges	1	$43	$43	—	—	—	$43 – $43
17	Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges	1	$43	$43	—	—	—	$43 – $43
18	Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient	1	$54	$54	—	—	—	$54 – $54
19	Endo Surgery Center Carmel, IN fee schedule · outpatient	8	$16	$16	—	—	—	$16 – $16
20	Fairview Hospital Cleveland, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
21	Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient	1	$11	$11	—	—	—	$11 – $11
22	LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient	1	$25	$25	—	—	—	$25 – $25
23	LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
24	MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
25	MEDINA HOSPITAL Medina, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15