Description |
Billing Code |
Billing Code Name |
CPT/HCPCS |
Patient Price |
COVID-19 Antibodies Test |
3008632801 |
SER IA NFCT AB SARSCOV2 COVID19 IN HOUSE |
86328 |
$101.90 |
COVID-19 Antibodies Test |
3008676901 |
SER IA NFCT AB SARSCOV2 COVID19 MULTI-STEP TOTAL |
86769 |
$101.90 |
COVID-19 Antibodies Test |
3068742601 |
COVID-19/SARS-COV-2 INHOUSE ANTIGEN IA |
87426 |
$94.80 |
COVID-19 Antibodies Test |
3068742801 |
IAAD IA SARS-COV-2 & INFLUENZA VIRUS TYPES A&B |
87428 |
$69.60 |
COVID-19 Test |
3008763501
|
COVID-19/SARS-COV-2 INF AGENT DET W/WO RESP W/CDC TEST KIT U0001 |
U0001 |
$0.01 |
COVID-19 Test |
306U000201 |
SARS-COVID-19 PCR NON-CDC TEST KIT/NON-HIGH THROUGHPUT
|
U0002 |
$115.45 |
COVID-19 Test |
300U000342
|
COVID-19/SARS-COV-2 HIGH THROUGHPUT INHOUSE INF AGT DET W/WO RESP U0003 |
U0003 |
$168.75 |
COVID-19 Test |
300U000341
|
COVID-19/SARS-COV-2 INF AGENT DET W/WO RESP NON-CDC SITE U0003 |
U0003 |
$168.75 |
COVID-19 Test |
300U000542
|
COVID-19/SARSCOV2 CEPHEID INHOUSE INF AGENT ADDON U0005 |
U0005 |
$56.25 |
COVID-19 Test |
300U000541
|
COVID-19/SARSCOV2 HIGH THROUGHPUT INF AGENT ADDON U0005 |
U0005 |
$56.25 |
Respiratory panel - 4 targets including COVID-19 |
3060241U01
|
COVID-19 0241U CEPHEID RNA 4 TGT RESP SPEC |
0241U |
$525.00 |
Respiratory panel - 22 targets including COVID-19 |
3060202U01
|
IN HOUSE BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2 |
0202U |
$1680.00 |
COVID-19 Vaccine - 1st dose (Pfizer) |
7710001A01 |
ADMIN SARSCOVID2 30MCG/0.3ML 1ST |
0001A |
$90.00 |
COVID-19 Vaccine - 2nd dose (Pfizer) |
7710002A01 |
ADMIN SARSCOVID2 30MCG/0.3ML 2ND |
0002A |
$90.00 |
COVID-19 Vaccine - 3rd dose (Pfizer) |
7710003A01 |
IM ADMIN, THIRD DOSE, SARS-COV2 VAC, 30MCG/0.3ML DOSE (PFIZER) |
0003A |
$90.00 |
COVID-19 Booster (Pfizer) |
7710004A01 |
IM ADMIN, BOOSTER DOSE, SARS-COV-2 Vaccine, 30 MCG/0.3 ML Dosage (Pfizer) |
0004A |
$90.00 |
COVID-19 Vaccine - 1st dose Tris-Sucrose (Pfizer) |
7710051A01 |
IM ADMIN, FIRST DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0051A |
$90.00 |
COVID-19 Vaccine - 2nd dose Tris-Sucrose (Pfizer) |
7710052A01 |
IM ADMIN, SECOND DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0052A |
$90.00 |
COVID-19 Vaccine - 3rd dose Tris-Sucrose (Pfizer) |
7710053A01 |
IM ADMIN, THIRD DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0053A |
$90.00 |
COVID-19 Booster Tris-Sucrose (Pfizer) |
7710054A01 |
IM ADMIN, BOOSTER DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0054A |
$90.00 |
COVID-19 1st dose Pediatric (Pfizer) |
7710071A01 |
IM ADMIN, FIRST DOSE, SARS-COV-2 Vaccine, 10 MCG/0.2 ML Pediatric Tris-sucrose (Pfizer) |
0071A |
$90.00 |
COVID-19 2nd dose Pediatric (Pfizer) |
7710072A01 |
IM ADMIN, SECOND DOSE, SARS-COV-2 Vaccine, 10 MCG/0.2 ML Pediatric Tris-sucrose (Pfizer) |
0072A |
$90.00 |
COVID-19 3rd dose Pediatric (Pfizer) |
7710073A01 |
IM ADMIN, THIRD DOSE, SARSCOV2, 10 MCG/0.2 ML, PEDIATRIC TRIS-SURCOSE (PFIZER) |
0073A |
$90.00 |
COVID-19 1st dose Pediatric (Pfizer) |
7710081A01 |
IM ADMIN, FIRST DOSE, SARSCOV2, 3 MCG/0.2 ML, PEDIATRIC TRIS-SURCOSE, 6MO to <5YRS (PFIZER) |
|
$90.00 |
COVID-19 2nd dose Pediatric (Pfizer) |
7710082A01
|
IM ADMIN, SECOND DOSE, SARSCOV2, 3 MCG/0.2 ML, PEDIATRIC TRIS-SURCOSE, 6MO to <5YRS (PFIZER) |
0013A |
$90.00 |
COVID-19 Vaccine - 1st dose (Moderna) |
7710011A01
|
ADMIN SARSCOVID2 100MCG/0.5ML1ST |
0011A |
$90.00 |
COVID-19 Vaccine - 2nd dose (Moderna) |
7710012A01 |
ADMIN SARSCOVID2 100MCG/0.5ML2ND |
0012A |
$90.00 |
COVID-19 Vaccine - 3rd dose (Moderna) |
7710013A01 |
IM ADMIN, THIRD DOSE, SARS-COV2 VAC, 100MCG/0.5ML (MODERNA) |
0013A |
$90.00 |
COVID-19 Vaccine - Booster dose (Moderna) |
7710064A01
|
IM ADMIN, BOOSTER DOSE, SARS-COV2 VAC, 100MCG/0.5ML (MODERNA) |
0064A |
$90.00 |
COVID-19 Treatment (IV Infusion) |
260M024901 |
IIV INFUSION, COVID-19, TOCILIZUMAB |
M0249 |
$1,031.65 |
COVID-19 Treatment (IV Infusion) |
335M024701 |
IV INFUSION, COVID-19, SOTROVIMAB |
M0247 |
$1,031.65 |
COVID-19 Treatment (IV Infusion) |
335M024501
|
IV INFUSION, COVID-19, BAMLANIVIMAB |
M0245 |
$1,031.65 |
COVID-19 Treatment (IV Infusion) |
335M024301 |
IV INFUSION, COVID-19, CASIRIVIMAB AND IMDEVIMAB |
M0243 |
$1,031.65 |
COVID-19 Treatment (injection) |
335M022001 |
COVID INJ, TIXAGEVIMAB and CILGAVIMAB, INCL POST ADMIN MONITOR |
M0220 |
$338.65 |
COVID-19 Treatment (Convalescent Plasma Admin) |
3913643001 |
IM ADMIN BLOOD TRANSFUSION DAILY |
36430 |
$1,071.54 |