CPT 0173A
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 3 Mcg/0.2 Ml 3rd Dose 6mo-4yrs
Low
$13
Average
$50
Median
$34
High
$150
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27 hospital rates
iThe hospitals that file a Optum 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 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 3 | Baylor Scott & White Medical Center - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 4 | Baylor University Medical Center Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 9 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 10 | Connecticut Children's Hartford, CT case rate · both | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 11 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 12 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 13 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 14 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 15 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 16 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 17 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 18 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 19 | OCHSNER CLINIC FOUNDATION LA 70121; 4430 Veterans Memorial Blvd.Metairie, LA other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 20 | OCHSNER MEDICAL CENTER � HANCOCK LLC Bay St. Louis, MS other · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 21 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · other · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 22 | The Children's Hospital of Alabama Birmingham, AL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 23 | The Cleveland Clinic Foundation Brunswick, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 24 | UMass Memorial Medical Center MA 01605; 157 Union Street Marlborough, MA percent of total billed charges · bothfrom % of charges | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 25 | University Hospital & Clinics, Inc. Lafayette, LA other · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
← Payers reporting CPT 0173A · Snapshot 20261113T090226Z-3ce6c0b8