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 A&B AG IA
Austin, TX
See all hospitals reporting CPT 87428 →Price type
Ascension Seton’s median price of $70 is 4% below the median hospital's median price ($73), higher than 17% of the 1,734 hospitals reporting CPT 87428. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 18 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 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $58.79 | $58.79 | $58.79 – $58.79 |
| 2 | Aetna 4659_medicare advantage aetna inpatient 20251001 other · inpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 3 | Aetna 4749_medicare advantage aetna outpatient 20250811 other · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 4 | Devoted 4684_medicare advantage devoted health inpatient 20251001 other · inpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 5 | Devoted 4918_medicare advantage devoted health outpatient 20250811 other · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 6 | Humana 4661_medicare advantage humana inpatient (aus,hay,nw,sw) 20251001 other · inpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 7 | Humana 4921_medicare advantage humana outpatient (aus,hay,nw,sw.smv) 20250811 other · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 8 | Tricare 4696_tricare inpatient 20251001 other · inpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 9 | WellCare 4691_medicare advantage wellcare inpatient 20251001 other · inpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 10 | WellCare 4929_medicare advantage wellcare outpatient 20250811 other · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 11 | UnitedHealthcare 4687_medicare advantage united healthcare inpatient (aus,nw,sw,hay) 20251001 other · inpatient | $71.70 | $71.70 | $71.70 – $71.70 |
| 12 | UnitedHealthcare 4928_medicare advantage united healthcare outpatient (aus,nw,sw,hay,smv) 20250811 other · outpatient | $71.70 | $71.70 | $71.70 – $71.70 |
| 13 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $119.43 | $119.43 | $119.43 – $119.43 |
| 14 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $119.43 | $119.43 | $119.43 – $119.43 |
| 15 | Ambetter 4652_superior ambetter inpatient 20251001 other · inpatient | $126.52 | $126.52 | $126.52 – $126.52 |
| 16 | Ambetter 4960_superior ambetter outpatient 20250811 other · outpatient | $126.52 | $126.52 | $126.52 – $126.52 |
| 17 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $131.80 | $131.80 | $131.80 – $131.80 |
| 18 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $145.73 | $145.73 | $145.73 – $145.73 |
Last updated: Jan 1, 2026
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