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Missouri rates for HCPCS 86695

Antibody; herpes simplex, type 1

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $22.91 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $45.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $6.61 / $13.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $13.18 / $45.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $11.22 / $33.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $26.92 / $29.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $24.55 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $13.49 / $19.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $22.91 / $81.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $7.94 / $15.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $13.18 / $16.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $7.94 / $15.85