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
RESP VIRUS 3-5 TARGET R1
Arlington, TX
See all hospitals reporting CPT 87631 →Price type
AMH Cath Labs LLC’s median price of $282 is 71% above the median hospital's median price ($165), higher than 79% of the 2,188 hospitals reporting CPT 87631. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 31 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 2 | UnitedHealthcare managed medicaid fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 3 | WellCare managed medicaid fee schedule · outpatient | $126 | $126 | — | — | — | $126 – $126 |
| 4 | Molina managed medicaid fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 5 | Aetna managed medicaid fee schedule · outpatient | $132 | $132 | — | — | — | $132 – $132 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $143 | $143 | — | — | — | $143 – $143 |
| 7 | UnitedHealthcare all payer fee schedule · outpatient | $143 | $143 | — | — | — | $143 – $143 |
| 8 | UnitedHealthcare ppo fee schedule · outpatient | $143 | $143 | — | — | — | $143 – $143 |
| 9 | Humana medicare advantage case rate · outpatient | $148 | $148 | — | — | — | $148 – $148 |
| 10 | Humana medicare advantage ppo case rate · outpatient | $148 | $148 | — | — | — | $148 – $148 |
| 11 | Molina medicare advantage case rate · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 12 | WellCare medicare advantage hmo case rate · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 13 | WellCare medicare advantage mmp case rate · outpatient | $157 | $157 | — | — | — | $157 – $157 |
| 14 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $158 | $158 | — | — | — | $158 – $158 |
| 15 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $161 | $161 | — | — | — | $161 – $161 |
| 16 | Blue Cross Blue Shield exchange fee schedule · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 17 | Blue Cross Blue Shield hmo fee schedule · outpatient | $282 | $282 | — | — | — | $282 – $282 |
| 18 | Blue Cross Blue Shield ppo fee schedule · outpatient | $314 | $314 | — | — | — | $314 – $314 |
| 19 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $310 | $320 | $50 | 16% | — | $263 – $386 |
| 20 | Aetna whole health fee schedule · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 21 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $389 | $402 | $63 | 16% | — | $331 – $485 |
| 22 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $390 | $403 | $64 | 16% | — | $332 – $486 |
| 23 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $393 | $405 | $64 | 16% | — | $334 – $489 |
| 24 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $393 | $405 | $64 | 16% | — | $334 – $489 |
| 25 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $417 | $431 | $68 | 16% | — | $355 – $520 |
Last updated: Apr 21, 2026
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