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Payers and negotiated rates for APC 0881 | medprice.ai

APC 0881

Hiv prep, oral lenacapavir

Payers reporting APC 0881

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Payer pricing summary

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Low

$235

Average

$456

Median

$449

High

$946

Payer rate distribution

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1	Aetna facility · fee schedule · outpatient · +3 other terms	5	$463	$460	$5	1%	—	$449 – $463
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +1 other terms	5	$951	$994	$465	47%	—	$418 – $1.7k
3	Humana facility · fee schedule · outpatient · +2 other terms	5	$465	$464	$1	0%	—	$463 – $465
4	Tricare facility · fee schedule · outpatient	5	$449	$449	—	—	—	$449 – $449
5	UnitedHealthcare facility · fee schedule · outpatient · +2 other terms	5	$449	$449	—	—	—	$449 – $449
6	WellCare facility · fee schedule · outpatient	5	$463	$462	$8	2%	—	$449 – $471
7	Cigna case rate · outpatient	2	$449	$449	—	—	—	$449 – $449
8	Excellus case rate · outpatient	2	$449	$449	—	—	—	$449 – $449
9	Highmark case rate · outpatient	2	$449	$449	—	—	—	$449 – $449
10	Aetna Better Health facility · case rate · outpatient	1	$346	$346	$112	32%	—	$235 – $458
11	Ambetter facility · case rate · outpatient	1	$235	$235	—	—	—	$235 – $235
12	Medicaid facility · case rate · outpatient	1	$235	$235	—	—	—	$235 – $235
13	Molina facility · case rate · outpatient	1	$346	$346	$112	32%	—	$235 – $458

← Hospitals reporting APC 0881 · Snapshot 20261111T120946Z-9134e7f7