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Vermont rates for HCPCS 86695

Antibody; herpes simplex, type 1

Facilitymedian $95 · 10th–90th $22–$1450%20%10th90th$95Professionalmedian $23 · 10th–90th $11–$230%20%40%10th$23$5.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $91.20 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $22.91 / $22.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $19.05 / $22.91
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $4.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $15.49 / $35.48