go back

Alaska rates for HCPCS 86696

Antibody; herpes simplex, type 2

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.38 / $104.34 / $212.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.80 / $64.81 / $74.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.47 / $53.47 / $53.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.16 / $22.30 / $27.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.55 / $17.55 / $17.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.35 / $19.35 / $77.40
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.73 / $74.50 / $124.85
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.42 / $43.54 / $175.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.55 / $17.55 / $67.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.35 / $25.02 / $27.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.17 / $38.70 / $58.38