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
Carthage, MS
See all hospitals reporting CPT 87428 →Price type
Baptist Memorial Hospital - Leake’s median price of $307 is 320% above the median hospital's median price ($73), higher than 99% 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: 10 payers, 19 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 commercial facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 2 | Molina medicaid facility · fee schedule · outpatient | $71.70 | $71.70 | $71.70 – $71.70 |
| 3 | Molina chip facility · fee schedule · outpatient | $123.01 | $123.01 | $123.01 – $123.01 |
| 4 | Tricare tricare facility · percent of total billed charges · outpatientfrom % of charges | $161.82 | $161.82 | $161.82 – $161.82 |
| 5 | UnitedHealthcare aarp facility · percent of total billed charges · outpatientfrom % of charges | $170.34 | $170.34 | $170.34 – $170.34 |
| 6 | Devoted medicare facility · percent of total billed charges · outpatientfrom % of charges | $173.75 | $173.75 | $173.75 – $173.75 |
| 7 | Blue Cross Blue Shield medicare facility · percent of total billed charges · outpatientfrom % of charges | $175.45 | $175.45 | $175.45 – $175.45 |
| 8 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $178.86 | $178.86 | $178.86 – $178.86 |
| 9 | Cigna medicare facility · percent of total billed charges · outpatientfrom % of charges | $178.86 | $178.86 | $178.86 – $178.86 |
| 10 | Humana medicare pho facility · percent of total billed charges · outpatientfrom % of charges | $178.86 | $178.86 | $178.86 – $178.86 |
| 11 | WellCare medicare facility · percent of total billed charges · outpatientfrom % of charges | $178.86 | $178.86 | $178.86 – $178.86 |
| 12 | Molina exchange facility · percent of total billed charges · outpatientfrom % of charges | $315.13 | $315.13 | $315.13 – $315.13 |
| 13 | MultiPlan complementary network facility · percent of total billed charges · inpatientfrom % of charges | $350.70 | $350.70 | $350.70 – $350.70 |
| 14 | MultiPlan complementary network facility · percent of total billed charges · outpatientfrom % of charges | $350.70 | $350.70 | $350.70 – $350.70 |
| 15 | MultiPlan mpi primary network facility · percent of total billed charges · inpatientfrom % of charges | $350.70 | $350.70 | $350.70 – $350.70 |
| 16 | MultiPlan mpi primary network facility · percent of total billed charges · outpatientfrom % of charges | $350.70 | $350.70 | $350.70 – $350.70 |
| 17 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $400.80 | $400.80 | $400.80 – $400.80 |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $400.80 | $400.80 | $400.80 – $400.80 |
| 19 | Humana ppo facility · percent of total billed charges · outpatientfrom % of charges | $425.85 | $425.85 | $425.85 – $425.85 |
Last updated: Feb 20, 2026
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