CPT 0164A

Moderna COVID-19 bivalent booster dose, ages 6 months to 4 years

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

Adm srscv2 bvl 10mcg/0.2ml b

Payer pricing summary

Low

$13

Average

$49

Median

$45

High

$127

Payer rate distribution

Filter by billing methodology

All methodologies Case rate 14 Fee schedule 27 Per diem 4 Percent of billed charges 30 Other 18

Filter by billing class

#
1	Aetna facility · percent of total billed charges · outpatientfrom % of charges · +8 other terms	50	$44	$37	$13	36%	—	$7 – $70
2	Humana facility · percent of total billed charges · outpatientfrom % of charges · +4 other terms	49	$56	$54	$9	17%	—	$31 – $78
3	Cigna facility · percent of total billed charges · outpatientfrom % of charges · +7 other terms	44	$43	$41	$9	22%	—	$14 – $70
4	UnitedHealthcare facility · percent of total billed charges · outpatientfrom % of charges · +8 other terms	42	$41	$39	$17	43%	—	$7 – $71
5	First Health facility · percent of total billed charges · inpatientfrom % of charges · +7 other terms	32	$56	$54	$7	14%	—	$28 – $56
6	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$43	$35	$9	27%	—	$10 – $46
7	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$12	$13	$4	32%	—	$6 – $25
8	Blue Cross Blue Shield facility · percent of total billed charges · outpatientfrom % of charges · +7 other terms	23	$50	$45	$13	30%	—	$11 – $70
9	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +8 other terms	20	$65	$63	$8	13%	—	$37 – $78
10	Molina facility · percent of total billed charges · outpatientfrom % of charges · +3 other terms	14	$44	$42	$8	20%	—	$30 – $69

Page 1 of 3 · 30 payers

← Hospitals reporting CPT 0164A · Snapshot 20261113T090226Z-3ce6c0b8