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Payers and negotiated rates for APC 0880 | medprice.ai

APC 0880

Hiv prep, inj, lenacapavir

Payers reporting APC 0880

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Payer pricing summary

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Low

$7

Average

$16

Median

$16

High

$40

Payer rate distribution

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1	Excellus case rate · outpatient	2	$16	$16	—	—	2–20	$16 – $16
2	Aetna facility · fee schedule · outpatient · +2 other terms	5	$17	$17	$0	1%	—	$16 – $17
3	Blue Cross Blue Shield facility · fee schedule · outpatient · +1 other terms	5	$41	$42	$14	33%	—	$17 – $61
4	Humana facility · fee schedule · outpatient · +2 other terms	5	$17	$17	$0	0%	—	$17 – $17
5	Tricare facility · fee schedule · outpatient	5	$16	$16	—	—	—	$16 – $16
6	UnitedHealthcare facility · fee schedule · outpatient · +2 other terms	5	$16	$16	—	—	—	$16 – $16
7	WellCare facility · fee schedule · outpatient	5	$7	$7	$0	2%	—	$7 – $7
8	Cigna case rate · outpatient	2	$16	$16	—	—	—	$16 – $16
9	Highmark case rate · outpatient	2	$16	$16	—	—	—	$16 – $16
10	Aetna Better Health facility · case rate · outpatient	1	$12	$12	$4	32%	—	$8 – $16
11	Ambetter facility · case rate · outpatient	1	$8	$8	—	—	—	$8 – $8
12	Medicaid facility · case rate · outpatient	1	$8	$8	—	—	—	$8 – $8
13	Molina facility · case rate · outpatient	1	$12	$12	$4	32%	—	$8 – $16

← Hospitals reporting APC 0880 · Snapshot 20261111T120946Z-9134e7f7