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
IA RESP VIRS 12-25 TARGET
Sacramento, CA
See all hospitals reporting CPT 87633 →Price type
Dignity Community Care’s median price of $391 is 18% below the median hospital's median price ($475), higher than 9% of the 2,357 hospitals reporting CPT 87633. 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, 37 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|aco trio fee schedule · outpatient | $288 | $288 | $144 | 50% | — | $144 – $431 |
| 2 | Kaiser medicaid|all plans fee schedule · outpatient | $319 | $319 | $159 | 50% | — | $159 – $478 |
| 3 | Blue Cross Blue Shield commercial|aco trio calpers fee schedule · outpatient | $365 | $365 | $183 | 50% | — | $183 – $548 |
| 4 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $370 | $370 | — | — | — | $370 – $370 |
| 5 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $370 | $370 | — | — | — | $370 – $370 |
| 6 | Anthem medicare|all other plans fee schedule · outpatient | $380 | $380 | $13 | 4% | — | $366 – $393 |
| 7 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $381 | $381 | $191 | 50% | — | $190 – $571 |
| 8 | Aetna medicare|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 9 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 10 | Humana commercial|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 11 | Humana medicare|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 12 | Kaiser medicare|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 13 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $403 | $403 | $14 | 4% | — | $388 – $417 |
| 14 | Anthem medicare|imperial fee schedule · outpatient | $415 | $415 | $15 | 4% | — | $400 – $429 |
| 15 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $444 | $444 | $56 | 13% | — | $388 – $500 |
| 16 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $444 | $444 | $56 | 13% | — | $388 – $500 |
| 17 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $444 | $444 | $56 | 13% | — | $388 – $500 |
| 18 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $444 | $444 | $56 | 13% | — | $388 – $500 |
| 19 | Molina medicaid|all plans fee schedule · outpatient | $542 | $542 | $154 | 28% | — | $388 – $696 |
| 20 | Anthem medicaid|all plans fee schedule · outpatient | $546 | $546 | $158 | 29% | — | $388 – $704 |
| 21 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $552 | $552 | $276 | 50% | — | $276 – $828 |
| 22 | Blue Cross Blue Shield commercial|calpers fee schedule · outpatient | $567 | $567 | $284 | 50% | — | $284 – $851 |
| 23 | Anthem commercial|brms fee schedule · outpatient | $583 | $583 | $292 | 50% | — | $291 – $875 |
| 24 | First Health commercial|all plans fee schedule · inpatient | $583 | $583 | $292 | 50% | — | $291 – $875 |
| 25 | First Health commercial|all plans fee schedule · outpatient | $583 | $583 | $292 | 50% | — | $291 – $875 |
Last updated: Feb 28, 2026
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