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Utah rates for HCPCS 86696

Antibody; herpes simplex, type 2

Facilitymedian $83 · 10th–90th $24–$1320%10%20%10th90th$83Professionalmedian $17 · 10th–90th $14–$240%20%40%10th90th$17$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
$38.90 / $85.11 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $17.38 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $20.42 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $13.18 / $37.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $87.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $16.60 / $17.38
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $19.50 / $61.66
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.50 / $28.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $12.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $11.48 / $26.92