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Utah rates for HCPCS 86695

Antibody; herpes simplex, type 1

Facilitymedian $56 · 10th–90th $15–$870%10%20%10th90th$56Professionalmedian $12 · 10th–90th $9–$160%50%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
$26.30 / $69.18 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $11.75 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $13.80 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $9.12 / $25.12
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $58.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $11.22 / $11.75
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $13.18 / $41.69
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $11.48 / $19.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $8.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $7.76 / $18.62