Description |
Billing Code |
Billing Code Name |
CPT/HCPCS |
Patient Price |
COVID-19 Antibodies Test |
3008632801 |
SER IA NFCT AB SARSCOV2 COVID19 IN HOUSE |
86328 |
$135.84 |
COVID-19 Antibodies Test |
3008676901 |
SER IA NFCT AB SARSCOV2 COVID19 MULTI-STEP TOTAL |
86769 |
$94.79 |
COVID-19 Antibodies Test |
3068742601 |
COVID-19/SARS-COV-2 INHOUSE ANTIGEN IA |
87426 |
$79.49 |
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 |
$153.93 |
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 |
$492.15 |
Respiratory panel - 22 targets including COVID-19 |
3060202U01
|
IN HOUSE BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2 |
0202U |
$1314.55 |
COVID-19 Vaccine - 1st dose (Pfizer) |
7710001A01 |
IM ADMINISTRATION SARSCOVID2 30MCG/0.3ML 1ST |
0001A |
$93.42 |
COVID-19 Vaccine - 2nd dose (Pfizer) |
7710002A01 |
IM ADMINISTRATION SARSCOVID2 30MCG/0.3ML 2ND |
0002A |
$93.42 |
COVID-19 Vaccine - 3rd dose (Pfizer) |
7710003A01 |
IM ADMINISTRATION, THIRD DOSE, SARS-COV2 VAC, 30MCG/0.3ML DOSE (PFIZER) |
0003A |
$93.42 |
COVID-19 Vaccine Booster (Pfizer) |
7710004A01 |
IM ADMINISTRATION, BOOSTER DOSE, SARS-COV-2 Vaccine, 30 MCG/0.3 ML Dosage (Pfizer) |
0004A |
$93.42 |
COVID-19 Vaccine - 1st dose Tris-Sucrose (Pfizer) |
7710051A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0051A |
$93.42 |
COVID-19 Vaccine - 2nd dose Tris-Sucrose (Pfizer) |
7710052A01 |
IM ADMINISTRATION, SECOND DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0052A |
$93.42 |
COVID-19 Vaccine - 3rd dose Tris-Sucrose (Pfizer) |
7710053A01 |
IM ADMINISTRATION, THIRD DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0053A |
$93.42 |
COVID-19 Vaccine Booster Tris-Sucrose (Pfizer) |
7710054A01 |
IM ADMINISTRATION, BOOSTER DOSE, SARSCOV2 30MCG/0.3ML TRIS-SUCROSE (PFIZER) |
0054A |
$93.42 |
COVID-19 Vaccine 1st dose Pediatric (Pfizer) |
7710071A01 |
IM ADMINISTRATION, FIRST DOSE, SARS-COV-2 Vaccine, 10 MCG/0.2 ML Pediatric Tris-sucrose (Pfizer) |
0071A |
$93.42 |
COVID-19 Vaccine 2nd dose Pediatric (Pfizer) |
7710072A01 |
IM ADMINISTRATION, SECOND DOSE, SARS-COV-2 Vaccine, 10 MCG/0.2 ML Pediatric Tris-sucrose (Pfizer) |
0072A |
$93.42 |
COVID-19 Vaccine 3rd dose Pediatric (Pfizer) |
7710073A01 |
IM ADMINISTRATION, THIRD DOSE, SARSCOV2, 10 MCG/0.2 ML, PEDIATRIC TRIS-SUCROSE (PFIZER) |
0073A |
$93.42 |
COVID-19 Vaccine Booster Pediatric Tris-Sucrose (Pfizer) |
7710074A01 |
IM ADMINISTRATION BOOSTER DOSE SARSCOV2, 10 MCG/0.2 ML, PEDIATRIC TRIS-SUCROSE (PFIZER) |
0074A |
$93.42 |
COVID-19 Vaccine 1st dose Pediatric (Pfizer) |
7710081A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2, 3 MCG/0.2 ML, PEDIATRIC TRIS-SUCROSE, 6MO to <5YRS (PFIZER) |
0081A |
$93.42 |
COVID-19 Vaccine 2nd dose Pediatric (Pfizer) |
7710082A01
|
IM ADMINISTRATION, SECOND DOSE, SARSCOV2, 3 MCG/0.2 ML, PEDIATRIC TRIS-SUCROSE, 6MO to <5YRS (PFIZER) |
0082A |
$93.42 |
COVID-19 Vaccine 3rd dose Pediatric (Pfizer) |
7710083A01
|
IM ADMINISTRATION, THIRD DOSE, SARSCOV2, 3 MCG/0.2 ML, PEDIATRIC TRIS-SUCROSE, 6MO to <5YRS (PFIZER) |
0083A |
$93.42 |
COVID-19 Vaccine - 1st dose (Moderna) |
7710011A01
|
ADMIN SARSCOVID2 100MCG/0.5ML1ST |
0011A |
$93.42 |
COVID-19 Vaccine - 2nd dose (Moderna) |
7710012A01 |
ADMIN SARSCOVID2 100MCG/0.5ML2ND |
0012A |
$93.42 |
COVID-19 Vaccine - 3rd dose (Moderna) |
7710013A01 |
IM ADMIN, THIRD DOSE, SARS-COV2 VAC, 100MCG/0.5ML (MODERNA) |
0013A |
$93.42 |
COVID-19 Vaccine - 1st dose (Moderna) |
7710111A01
|
IM ADMINISTRATON, FIRST DOSE, SARSCOV2 25 MCG/0.25 ML (MODERNA) |
0111A |
$93.42 |
COVID-19 Vaccine - 2nd dose (Moderna) |
7710112A01
|
IM ADMINISTRATON, SECOND DOSE, SARSCOV2 25 MCG/0.25 ML (MODERNA) |
0112A |
$93.42 |
COVID-19 Vaccine - 3rd dose (Moderna) |
7710113A01
|
IM ADMIN, THIRD DOSE, SARS-COV2 VAC, 100MCG/0.5ML (MODERNA) |
0113A |
$93.42 |
COVID-19 Vaccine - Booster dose (Moderna) |
7710064A01
|
IM ADMINISTRATION, BOOSTER DOSE, SARS-COV2 VACCINE, 100MCG/0.5ML (MODERNA) |
0064A |
$93.42 |
COVID-19 Vaccine - 1st dose (Moderna) |
7710091A01
|
IM ADMINISTRATON, FIRST DOSE, SARSCOV2 50 MCG/0.5 ML, 6-11 YRS (MODERNA) |
0091A |
$93.42 |
COVID-19 Vaccine - 2nd dose (Moderna) |
7710092A01
|
IM ADMINISTRATON, SECOND DOSE, SARSCOV2 50 MCG/0.5 ML, 6-11 YRS (MODERNA) |
0092A |
$93.42 |
COVID-19 Vaccine - 3rd dose (Moderna) |
7710093A01
|
IM ADMINISTRATON, THIRD DOSE, SARSCOV2 50 MCG/0.5 ML, 6-11 YRS (MODERNA) |
0093A |
$93.42 |
COVID-19 Vaccine Booster (Moderna) |
7710094A01 |
IM ADMIN, BOOSTER DOSE, SARSCOV2 VACCINE, 50 MCG/0.5 ML (MODERNA) |
0094A |
$93.42 |
COVID-19 Vaccine - 1st dose (Jannsen) |
7710031A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 VACCINE, ADS 25 0.5ML (Janssen) |
0031A |
$93.42 |
COVID-19 Vaccine - Booster (Jannsen) |
7710034A01 |
IM ADMINISTRATION, BOOSTER DOSE, SARSCOV2 VACCINE, ADS 25 0.5ML (Janssen) |
00341A |
$93.42 |
COVID-19 Vaccine - 1st dose (AstraZeneca) |
7710021A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 VACCINE, ADS 25 0.5ML (AstraZeneca) |
0021A |
$93.42 |
COVID-19 Vaccine - 2nd dose (AstraZeneca) |
7710031A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 VACCINE, ADS 25 0.5ML (AstraZeneca) |
0031A |
$93.42 |
COVID-19 Vaccine - 1st dose (Novavax) |
7710041A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 VACCINE, SMCG 0.5ML (Novavax) |
0041A |
$93.42 |
COVID-19 Vaccine - 2nd dose (Novavax) |
7710042A01 |
IM ADMINISTRATION, FIRST DOSE, SARSCOV2 VACCINE, SMCG 0.5ML (Novavax) |
0042A |
$93.42 |
COVID-19 Treatment (IV Infusion) |
260M024901 |
IV INFUSION, COVID-19, TOCILIZUMAB |
M0249 |
$1,351.50 |
COVID-19 Treatment (IV Infusion) |
335M024701 |
IV INFUSION, COVID-19, SOTROVIMAB |
M0247 |
$1,351.50 |
COVID-19 Treatment (IV Infusion) |
335M024501
|
IV INFUSION, COVID-19, BAMLANIVIMAB/ESTESEVIMAB |
M0245 |
$1,351.50 |
COVID-19 Treatment (IV Infusion) |
335M024301 |
IV INFUSION, COVID-19, CASIRIVIMAB AND IMDEVIMAB |
M0243 |
$1,351.50
|
COVID-19 Treatment (injection) |
335M022201 |
COVID INJ, BEBTELOVIMAB, INCL POST ADMIN MONITOR |
M0222 |
$1,051.50 |
COVID-19 Treatment (injection) |
335M022001 |
COVID INJ, TIXAGEVIMAB and CILGAVIMAB, INCL POST ADMIN MONITOR |
M0220 |
$451.50 |
COVID-19 Treatment (Convalescent Plasma Admin) |
3913643001 |
IM ADMIN BLOOD TRANSFUSION DAILY |
36430 |
$1,437.10 |