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

Tricare pricing summary

Low

$28

Average

$40

Median

$35

High

$77

Tricare rate distribution

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23 hospital rates

#		Plans
1	ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient	1	$60	$60	—	—	—	$60 – $60
2	Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges	1	$29	$29	—	—	—	$29 – $29
3	Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges	1	$28	$28	—	—	—	$28 – $28
4	Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges	1	$28	$28	—	—	—	$28 – $28
5	Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges	1	$36	$36	—	—	—	$36 – $36
6	LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient	1	$60	$60	—	—	—	$60 – $60
7	PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
8	PRISMA HEALTH BLOUNT MEMORIAL HOSPITAL MARYVILLE, TN fee schedule · both	1	$37	$37	—	—	—	$37 – $37
9	PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
10	PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
11	PRISMA HEALTH HILLCREST HOSPITAL SIMPSONVILLE, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
12	PRISMA HEALTH LAURENS COUNTY HOSPITAL CLINTON, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
13	PRISMA HEALTH NORTH GREENVILLE LTACH HOSPITAL TRAVELERS REST, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
14	PRISMA HEALTH OCONEE MEMORIAL HOSPITAL SENECA, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
15	PRISMA HEALTH PATEWOOD HOSPITAL GREENVILLE, SC fee schedule · both	1	$35	$35	—	—	—	$35 – $35
16	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
17	St. Charles Madras Madras, OR percent of total billed charges · bothfrom % of charges	1	$35	$35	—	—	—	$35 – $35
18	St. Charles Prineville Prineville, OR percent of total billed charges · bothfrom % of charges	1	$34	$34	—	—	—	$34 – $34
19	University Hospital & Clinics, Inc. Lafayette, LA other · outpatient	1	$60	$60	—	—	—	$60 – $60
20	University of Virginia Culpeper Medical Center Culpeper, VA fee schedule · both	1	$39	$39	—	—	—	$39 – $39
21	University of Virginia Haymarket Medical Center Haymarket, VA fee schedule · both	1	$39	$39	—	—	—	$39 – $39
22	University of Virginia Medical Center Charlottesville, VA fee schedule · both	1	$39	$39	—	—	—	$39 – $39
23	University of Virginia Prince William Medical Center Manassas, VA fee schedule · both	1	$39	$39	—	—	—	$39 – $39

← Payers reporting CPT 0173A · Snapshot 20261113T090226Z-3ce6c0b8