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
Tazewell, TN
See all hospitals reporting CPT 87428 →Price type
Claiborne Medical Center’s median price of $79 is 8% above the median hospital's median price ($73), higher than 70% 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, 30 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 tenncare fee schedule · outpatient | $34.33 | $34.33 | $34.33 – $34.33 |
| 2 | Ambetter exchange fee schedule · outpatient | $56.00 | $56.00 | $56.00 – $56.00 |
| 3 | UnitedHealthcare all other plans fee schedule · outpatient | $73.57 | $73.57 | $73.57 – $73.57 |
| 4 | UnitedHealthcare heritage select fee schedule · outpatient | $73.57 | $73.57 | $73.57 – $73.57 |
| 5 | UnitedHealthcare options ppo fee schedule · outpatient | $73.57 | $73.57 | $73.57 – $73.57 |
| 6 | Optum va ccn fee schedule · outpatient | $75.28 | $75.28 | $75.28 – $75.28 |
| 7 | Tricare humana military fee schedule · outpatient | $75.28 | $75.28 | $75.28 – $75.28 |
| 8 | Humana dsnp fee schedule · outpatient | $77.54 | $77.54 | $77.54 – $77.54 |
| 9 | Humana medicare advantage hmo fee schedule · outpatient | $77.54 | $77.54 | $77.54 – $77.54 |
| 10 | Humana medicare advantage ppo fee schedule · outpatient | $77.54 | $77.54 | $77.54 – $77.54 |
| 11 | UnitedHealthcare community plan dsnp fee schedule · outpatient | $77.54 | $77.54 | $77.54 – $77.54 |
| 12 | UnitedHealthcare medicare advantage fee schedule · outpatient | $77.54 | $77.54 | $77.54 – $77.54 |
| 13 | Aetna medicare advantage fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 14 | Blue Cross Blue Shield blueessential dsnp fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 15 | Blue Cross Blue Shield blueessential hmo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 16 | Blue Cross Blue Shield med adv diamond fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 17 | Blue Cross Blue Shield med adv ppo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 18 | Blue Cross Blue Shield med adv ruby fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 19 | Blue Cross Blue Shield med adv sapphire fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 20 | Cigna medicare hmo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 21 | Cigna medicare hmo-pos fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 22 | Cigna medicare ppo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 23 | Devoted hmo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 24 | Devoted ppo fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
| 25 | UnitedHealthcare dsnp fee schedule · outpatient | $79.04 | $79.04 | $79.04 – $79.04 |
Last updated: Aug 5, 2026
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