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
HC ADM SARSCOV2 5MCGM/0.5ML BST
Garrison, ND
See all hospitals reporting CPT 0104A →Price type
Garrison Memorial Hospital’s median price of $62 is 30% above the median hospital's median price ($48), higher than 74% 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: 6 payers, 13 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 | Humana medicare|all plans fee schedule · outpatient | $37 | $37 | — | — | — | $37 – $37 |
| 2 | Medica medicare|all plans fee schedule · outpatient | $37 | $37 | — | — | — | $37 – $37 |
| 3 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $37 | $37 | — | — | — | $37 – $37 |
| 4 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $37 | $37 | — | — | — | $37 – $37 |
| 5 | UnitedHealthcare commercial|all plans fee schedule · inpatient | $54 | $54 | — | — | — | $54 – $54 |
| 6 | UnitedHealthcare commercial|all plans fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 7 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 8 | Medica commercial|all plans fee schedule · inpatient | $64 | $64 | — | — | — | $64 – $64 |
| 9 | Medica commercial|all plans fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 10 | MultiPlan commercial|all plans fee schedule · inpatient | $66 | $66 | — | — | — | $66 – $66 |
| 11 | MultiPlan commercial|all plans fee schedule · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 12 | Sanford Health Plan commercial|all plans fee schedule · inpatient | $69 | $69 | — | — | — | $69 – $69 |
| 13 | Sanford Health Plan commercial|all plans fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
Last updated: Feb 28, 2026
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