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
Mayfield Heights, OH
See all hospitals reporting CPT 87428 →Price type
Cleveland Clinic Health System - East Region’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: 9 payers, 17 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 | Optum managed medicaid transplant facility · case rate · outpatient | $28.70 | $28.70 | $28.70 – $28.70 |
| 2 | Anthem managed medicaid facility · case rate · outpatient | $31.72 | $31.72 | $31.72 – $31.72 |
| 3 | Molina managed medicaid facility · case rate · outpatient | $31.72 | $31.72 | $31.72 – $31.72 |
| 4 | Caresource managed medicaid facility · case rate · outpatient | $32.32 | $32.32 | $32.32 – $32.32 |
| 5 | UnitedHealthcare managed medicaid facility · case rate · outpatient | $32.32 | $32.32 | $32.32 – $32.32 |
| 6 | Optum all products va facility · fee schedule · outpatient | $63.59 | $63.59 | $63.59 – $63.59 |
| 7 | Aetna medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 8 | Anthem medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 9 | Devoted medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 10 | Humana medicare advantage hmo facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 11 | Optum medicare advantage transplant facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 12 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 13 | Cigna medicare advantage facility · fee schedule · outpatient | $72.40 | $72.40 | $72.40 – $72.40 |
| 14 | Aetna international facility · fee schedule · outpatient | $94.01 | $94.01 | $94.01 – $94.01 |
| 15 | Anthem hpn facility · fee schedule · outpatient | $110.49 | $110.49 | $110.49 – $110.49 |
| 16 | Anthem ppo/hmo facility · fee schedule · outpatient | $129.99 | $129.99 | $129.99 – $129.99 |
| 17 | UnitedHealthcare all products facility · fee schedule · outpatient | $165.65 | $165.65 | $165.65 – $165.65 |
Last updated: Jun 15, 2026
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