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Indiana rates for HCPCS 86696

Antibody; herpes simplex, type 2

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.35 / $60.00 / $143.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.32 / $17.29 / $33.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.29 / $17.68 / $58.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.16 / $9.56 / $14.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.35 / $21.29 / $27.09
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.58 / $20.32 / $26.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.16 / $19.35 / $50.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.74 / $22.30 / $48.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.29 / $14.61 / $27.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $11.64 / $21.27