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
HC IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B
Rowlett, TX
See all hospitals reporting CPT 87428 →Price type
Baylor Scott & White Medical Center - Lake Pointe’s median price of $67 is 8% below the median hospital's median price ($73), higher than 11% 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, 28 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 | UnitedHealthcare charter facility · fee schedule · outpatient | $10.00 | $10.00 | $10.00 – $10.00 |
| 2 | UnitedHealthcare nexus facility · fee schedule · outpatient | $10.00 | $10.00 | $10.00 – $10.00 |
| 3 | UnitedHealthcare commercial broad facility · fee schedule · outpatient | $11.00 | $11.00 | $11.00 – $11.00 |
| 4 | Cigna local plus facility · percent of total billed charges · outpatientfrom % of charges | $36.24 | $36.24 | $36.24 – $36.24 |
| 5 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $40.42 | $40.42 | $40.42 – $40.42 |
| 6 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $42.63 | $42.63 | $42.63 – $42.63 |
| 7 | First Health ppo facility · percent of total billed charges · inpatientfrom % of charges | $51.45 | $51.45 | $51.45 – $51.45 |
| 8 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $51.45 | $51.45 | $51.45 – $51.45 |
| 9 | Humana commercial ppo facility · percent of total billed charges · outpatientfrom % of charges | $51.45 | $51.45 | $51.45 – $51.45 |
| 10 | Superior Healthplan medicaid facility · fee schedule · outpatient | $59.04 | $59.04 | $59.04 – $59.04 |
| 11 | UnitedHealthcare medicaid/chip facility · fee schedule · outpatient | $63.17 | $63.17 | $63.17 – $63.17 |
| 12 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $66.78 | $66.78 | $66.78 – $66.78 |
| 13 | Humana medicare facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 14 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $73.80 | $73.80 | $73.80 – $73.80 |
| 15 | Molina medicare advantage facility · fee schedule · outpatient | $73.80 | $73.80 | $73.80 – $73.80 |
| 16 | Superior Healthplan medicare facility · fee schedule · outpatient | $73.80 | $73.80 | $73.80 – $73.80 |
| 17 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $78.72 | $78.72 | $78.72 – $78.72 |
| 18 | Baylor Scott White Health Plan bsw premier - small group facility · fee schedule · outpatient | $84.35 | $84.35 | $84.35 – $84.35 |
| 19 | Baylor Scott White Health Plan bsw premier - individual facility · fee schedule · outpatient | $88.21 | $88.21 | $88.21 – $88.21 |
| 20 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · fee schedule · outpatient | $107.10 | $107.10 | $107.10 – $107.10 |
| 21 | Blue Cross Blue Shield blue advantage facility · fee schedule · outpatient | $112.62 | $112.62 | $112.62 – $112.62 |
| 22 | Baylor Scott White Health Plan bsw plus - small group facility · fee schedule · outpatient | $115.98 | $115.98 | $115.98 – $115.98 |
| 23 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · fee schedule · outpatient | $126.00 | $126.00 | $126.00 – $126.00 |
| 24 | Ambetter ambetter exchange facility · fee schedule · outpatient | $151.12 | $151.12 | $151.12 – $151.12 |
| 25 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · fee schedule · outpatient | $159.34 | $159.34 | $159.34 – $159.34 |
Last updated: Jun 29, 2026
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