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Maine rates for HCPCS 86696

Antibody Herpes Smplx Type 2

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.75 / $58.25 / $147.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.67 / $23.14 / $29.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $25.83 / $202.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.74 / $7.74 / $22.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.83 / $26.86 / $41.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $26.34 / $27.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.35 / $19.35 / $23.43
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.35 / $79.61 / $160.13
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.67 / $22.37 / $38.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.61 / $15.82 / $38.24