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
Adm Sarscv2 10 Mcg/0.2 Ml Sanofi-Gsk Booster Dose Ages 18 and Up
Eureka, IL
See all hospitals reporting CPT 0104A →Price type
Carle Eureka Hospital’s median price of $71 is 49% above the median hospital's median price ($48), higher than 83% of the 166 hospitals reporting CPT 0104A. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 16 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 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 2 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 3 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 4 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 5 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 6 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 7 | UnitedHealthcare va ccn/optum percent of total billed charges · outpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $57 | $57 | — | — | — | $57 – $57 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $73 | $73 | — | — | — | $73 – $73 |
| 10 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $73 | $73 | — | — | — | $73 – $73 |
| 11 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $74 | $74 | — | — | — | $74 – $74 |
| 12 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $79 | $79 | — | — | — | $79 – $79 |
| 13 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $79 | $79 | — | — | — | $79 – $79 |
| 14 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $80 | $80 | — | — | — | $80 – $80 |
| 15 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $89 | $89 | — | — | — | $89 – $89 |
| 16 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $100 | $100 | — | — | — | $100 – $100 |
Last updated: Apr 15, 2026
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