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
SARSCOV INF VIR AB AG IA
The hospitals that file a Premera 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.
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42 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 1 | $70.29 | $70.29 – $70.29 |
| 2 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 1 | $70.29 | $70.29 – $70.29 |
| 3 | Central Washington Health Services Association Wenatchee, WA fee schedule · outpatient | 4 | $219.71 | $112.46 – $237.58 |
| 4 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 3 | $76.15 | $70.29 – $87.86 |
| 5 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 3 | $76.15 | $70.29 – $87.86 |
| 6 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · inpatient | 1 | $70.29 | $70.29 – $70.29 |
| 7 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · outpatient | 1 | $70.29 | $70.29 – $70.29 |
| 8 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · inpatient | 1 | $70.29 | $70.29 – $70.29 |
| 9 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · outpatient | 1 | $70.29 | $70.29 – $70.29 |
| 10 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 3 | $76.15 | $70.29 – $87.86 |
| 11 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 3 | $87.86 | $87.86 – $87.86 |
| 12 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 3 | $76.15 | $70.29 – $87.86 |
| 13 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 3 | $87.86 | $87.86 – $87.86 |
| 14 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 3 | $87.86 | $87.86 – $87.86 |
| 15 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 3 | $87.86 | $87.86 – $87.86 |
| 16 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · outpatient | 1 | $48.49 | $48.49 – $48.49 |
| 17 | Public Hospital Dist No 1 Skagit dba Cascade Valley Hospital Arlington, WA fee schedule · both | 1 | $1,502 | $1,502 – $1,502 |
| 18 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · outpatient | 1 | $79.04 | $79.04 – $79.04 |
| 19 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $162.75 | $162.75 – $162.75 |
| 20 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $114.14 | $114.14 – $114.14 |
| 21 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · fee schedule · both | 1 | $123.01 | $123.01 – $123.01 |
| 22 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $114.14 | $114.14 – $114.14 |
| 23 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · inpatient | 1 | $71.70 | $71.70 – $71.70 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 1 | $71.70 | $71.70 – $71.70 |
| 25 | Samaritan Hospital Troy, NY facility · fee schedule · both | 1 | $322.52 | $322.52 – $322.52 |
← Payers reporting CPT 87428 · Snapshot 20261108T203506Z-bb90dbab