CPT 0173A

Pfizer COVID-19 bivalent booster dose for children 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

Imm Admn Sarscov2 Bvl 3 Mcg/0.2 Ml 3rd Dose 6mo-4yrs

Anthem pricing summary

Low

$11

Average

$39

Median

$28

High

$192

Anthem rate distribution

Filter by billing methodology

Filter by billing class

96 hospital rates

#		Plans
1	AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
2	Acadia Hospital Bangor, ME professional · fee schedule · outpatient	1	$26	$26	—	—	—	$26 – $26
3	Ascension St. Vincent Heart Center Carmel, IN fee schedule · both	2	$39	$39	—	—	—	$39 – $39
4	Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient	8	$25	$25	—	—	—	$25 – $25
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 · both	2	$39	$39	—	—	—	$39 – $39
12	Carmel AmbSurg Carmel, IN fee schedule · outpatient	8	$25	$25	—	—	—	$25 – $25
13	Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges	3	$59	$60	$2	3%	—	$59 – $62
14	Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges	3	$62	$62	—	—	—	$62 – $62
15	Children's National Hospital Washington, DC professional · fee schedule · both	1	$41	$41	—	—	—	$41 – $41
16	Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
17	Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges	1	$43	$43	—	—	—	$43 – $43
18	Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges	1	$43	$43	—	—	—	$43 – $43
19	Deaconess Health System Henderson Hospital Henderson, KY facility · fee schedule · outpatient	4	$19	$19	—	—	—	$19 – $19
20	Deaconess Health System Union County Hospital Morganfield, KY facility · fee schedule · outpatient	4	$19	$19	—	—	—	$19 – $19
21	Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient	1	$54	$54	—	—	—	$54 – $54
22	Endo Surgery Center Carmel, IN fee schedule · both	2	$39	$39	—	—	—	$39 – $39
23	Endo Surgery Center Carmel, IN fee schedule · outpatient	8	$25	$25	—	—	—	$25 – $25
24	Fairview Hospital Cleveland, OH facility · case rate · outpatient	1	$15	$15	—	—	—	$15 – $15
25	Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient	1	$11	$11	—	—	—	$11 – $11