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
Imm Admn Sarscov2 Bvl 30 Mcg/0.3 Ml Addl Dose
Low
$28
Average
$41
Median
$38
High
$77
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 2.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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18 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 2 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 3 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 4 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 5 | East Liverpool City Hospital Liverpool, OH fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 6 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 7 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 8 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 9 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 10 | Lower Bucks Hospital Bristol, PA fee schedule · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 11 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 12 | St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 13 | St. Charles Prineville Prineville, OR percent of total billed charges · bothfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 14 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 15 | University of Virginia Culpeper Medical Center Culpeper, VA fee schedule · both | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 16 | University of Virginia Haymarket Medical Center Haymarket, VA fee schedule · both | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 17 | University of Virginia Medical Center Charlottesville, VA fee schedule · both | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 18 | University of Virginia Prince William Medical Center Manassas, VA fee schedule · both | 1 | $39 | $39 | — | — | — | $39 – $39 |
← Payers reporting CPT 0124A · Snapshot 20261113T090226Z-3ce6c0b8