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
DYER, IN
See all hospitals reporting CPT 87428 →Price type
FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER’s median price of $109 is 49% above the median hospital's median price ($73), higher than 86% 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: 7 payers, 45 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 | Bcbs In anthem blue access ppo-cid fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 2 | Blue Cross Blue Shield anthem blue access ppo-cid fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 3 | Medicaid anthem care connect [315015] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 4 | Medicaid anthem healthy indiana plan [301498] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 5 | Medicaid anthem medicaid [109201] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 6 | Medicaid anthem pathways for aging [324049] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 7 | Medicaid humana healthy horizons in indiana [324050] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 8 | Medicaid in mcd-nir-dyer fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 9 | Medicaid mdwise excel hhw [318029] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 10 | Medicaid mdwise excel hip [318028] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 11 | Medicaid medicaid in traditional [109206] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 12 | Medicaid united healthcare care connect [321005] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 13 | Medicaid united healthcare pathways for the aging [324051] fee schedule · both | $70.29 | $70.29 | $70.29 – $70.29 |
| 14 | Medicaid caresource hhw [316039] fee schedule · both | $84.35 | $84.35 | $84.35 – $84.35 |
| 15 | Medicaid caresource hip [316038] fee schedule · both | $84.35 | $84.35 | $84.35 – $84.35 |
| 16 | Medicaid in mcd dyer caresource 120% of in mcd fee schedule · both | $84.35 | $84.35 | $84.35 – $84.35 |
| 17 | UnitedHealthcare bind/surest insurance [322006] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 18 | UnitedHealthcare definity health claims [115602] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 19 | UnitedHealthcare uhc nid-hammond-dyer-munster-crn point per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 20 | UnitedHealthcare united healthcare choice [315037] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 21 | UnitedHealthcare united healthcare core [321009] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 22 | UnitedHealthcare united healthcare hmo [115604] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 23 | UnitedHealthcare united healthcare navigate [321010] per diem · both | $100.00 | $100.00 | $100.00 – $100.00 |
| 24 | UnitedHealthcare uhc options ppo-nid-ham-dyer-mun-crn pt per diem · both | $109.00 | $109.00 | $109.00 – $109.00 |
| 25 | UnitedHealthcare united healthcare [115607] per diem · both | $109.00 | $109.00 | $109.00 – $109.00 |
Last updated: Jan 1, 2026
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