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
San Marcos, TX
See all hospitals reporting CPT 87428 →Price type
Santa Rosa Hospital - San Marcos’s median price of $71 is 3% below the median hospital's median price ($73), higher than 39% 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, 14 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 Tx star kids km fee schedule · outpatient | $31.56 | $31.56 | $31.56 – $31.56 |
| 2 | Bcbs Tx star km fee schedule · outpatient | $31.56 | $31.56 | $31.56 – $31.56 |
| 3 | Humana mm fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 4 | UnitedHealthcare mm fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 5 | WellCare mm fee schedule · outpatient | $70.29 | $70.29 | $70.29 – $70.29 |
| 6 | Aetna mm fee schedule · outpatient | $71.70 | $71.70 | $71.70 – $71.70 |
| 7 | Cigna healthspring medicare advantage mm fee schedule · outpatient | $72.40 | $72.40 | $72.40 – $72.40 |
| 8 | Devoted mm fee schedule · outpatient | $75.91 | $75.91 | $75.91 – $75.91 |
| 9 | Bcbs Tx hmo fee schedule · outpatient | $118.81 | $118.81 | $118.81 – $118.81 |
| 10 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $126.85 | $126.85 | $126.85 – $126.85 |
| 11 | Bcbs Tx ppo fee schedule · outpatient | $129.95 | $129.95 | $129.95 – $129.95 |
| 12 | Bcbs Tx heb fee schedule · outpatient | $141.09 | $141.09 | $141.09 – $141.09 |
| 13 | UnitedHealthcare all payer fee schedule · outpatient | $145.00 | $145.00 | $145.00 – $145.00 |
| 14 | Healthcare Highways ppo fee schedule · outpatient | $158.15 | $158.15 | $158.15 – $158.15 |
Last updated: Jan 13, 2026
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