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
Lebanon, NH
See all hospitals reporting CPT 87428 →Price type
Mary Hitchcock Memorial Hospital’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: 8 payers, 47 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Anthem anthem - indemnity/federal employee program professional · fee schedule · outpatient | $32.15 | $32.15 | $32.15 – $32.15 |
| 2 | Anthem anthem hmo/pos; individual non qhp on or off exch; shop off exch - dhp professional · fee schedule · outpatient | $32.15 | $32.15 | $32.15 – $32.15 |
| 3 | Anthem anthem indiv qhp - exchange - dhp professional · fee schedule · outpatient | $32.15 | $32.15 | $32.15 – $32.15 |
| 4 | Anthem anthem ppo - dhp professional · fee schedule · outpatient | $32.15 | $32.15 | $32.15 – $32.15 |
| 5 | Anthem anthem shop - exchange - dhp professional · fee schedule · outpatient | $32.15 | $32.15 | $32.15 – $32.15 |
| 6 | UnitedHealthcare uhc - hmo/pos/ppo - dhp professional · fee schedule · outpatient | $35.85 | $35.85 | $35.85 – $35.85 |
| 7 | UnitedHealthcare uhc - tiered freedom plan professional · fee schedule · outpatient | $46.09 | $46.09 | $46.09 – $46.09 |
| 8 | UnitedHealthcare uhc - freedom plan - dhp professional · fee schedule · outpatient | $51.22 | $51.22 | $51.22 – $51.22 |
| 9 | Amerihealth Caritas amerihealth caritas - nh managed medicaid facility · fee schedule · outpatient | $62.62 | $62.62 | $62.62 – $62.62 |
| 10 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $62.62 | $62.62 | $62.62 – $62.62 |
| 11 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · fee schedule · outpatient | $63.59 | $63.59 | $63.59 – $63.59 |
| 12 | Anthem anthem - medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 13 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 14 | Bcbs Vt bcbs of vermont - medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 15 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 16 | UnitedHealthcare uhc - medicare advantage facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 17 | UnitedHealthcare uhc - va community care network facility · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 18 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 19 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 20 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 21 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $72.39 | $72.39 | $72.39 – $72.39 |
| 22 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $72.39 | $72.39 | $72.39 – $72.39 |
| 23 | Aetna aetna medicare advantage facility · fee schedule · outpatient | $72.40 | $72.40 | $72.40 – $72.40 |
| 24 | Bcbs Vt bcbs of vermont - the vermont health plan professional · fee schedule · outpatient | $72.40 | $72.40 | $72.40 – $72.40 |
| 25 | Cigna cigna medicare advantage facility · fee schedule · outpatient | $72.40 | $72.40 | $72.40 – $72.40 |
Last updated: Jan 1, 2026
See Rapid antigen test for infectious agents pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.