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South Dakota rates for HCPCS 86695

Antibody; herpes simplex, type 1

Facilitymedian $71 · 10th–90th $15–$2750%10%20%10th90th$71Professionalmedian $12 · 10th–90th $10–$980%20%10th90th$12$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $77.62 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $12.02 / $97.72
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $19.95
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $13.49 / $13.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $25.70 / $31.62
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $20.42 / $77.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $7.94 / $18.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.90 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $11.75 / $18.62
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18