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Michigan rates for HCPCS 86695

Antibody; herpes simplex, type 1

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $15.85 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $11.75 / $23.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $6.61 / $10.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $14.79 / $26.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $10.00 / $10.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $13.80 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $15.14 / $19.05
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $15.85 / $58.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $15.14 / $26.92
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $10.47 / $16.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $13.18 / $13.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $10.72 / $11.48