Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HB Ref Epstein-Barr Capsid Vca
Low
$10
Average
$72
Median
$54
High
$434
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
120 hospitals; the 90th percentile is 8.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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189 hospital rates
iThe hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $23 | $23 | — | — | 112 | $23 – $23 |
| 2 | Grundy County Memorial Hospital Grundy Center, IA facility · other · outpatient | 2 | $21 | $21 | $1 | 5% | 6–60 | $20 – $22 |
| 3 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $23 | $23 | — | — | 4–40 | $23 – $23 |
| 4 | Osceola Regional Health Center Sibley, IA case rate · outpatient | 2 | $23 | $23 | — | — | 4–40 | $23 – $23 |
| 5 | Regional Health Services of Howard County Cresco, IA case rate · outpatient | 2 | $22 | $22 | — | — | 4–40 | $22 – $22 |
| 6 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $22 | $22 | — | — | 4–40 | $22 – $22 |
| 7 | Spencer Municipal Hospital Spencer, IA fee schedule · outpatient | 3 | $40 | $34 | $11 | 33% | 4–40 | $18 – $44 |
| 8 | Avera Gregory Hospital Gregory, SD outpatient | 1 | $77 | $77 | — | — | 2–20 | $77 – $77 |
| 9 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 1 | $220 | $220 | — | — | 2–20 | $220 – $220 |
| 10 | Avera Missouri River Health Center Gettysburg, SD outpatient | 1 | $77 | $77 | — | — | 2–20 | $77 – $77 |
| 11 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | 2–20 | $81 – $81 |
| 12 | Avera Queen of Peace Mitchell, SD outpatient | 1 | $25 | $25 | — | — | 2–20 | $25 – $25 |
| 13 | Avera Queen of Peace Mitchell, SD case rate · outpatient | 1 | $25 | $25 | — | — | 2–20 | $25 – $25 |
| 14 | Avera Sacred Heart Hospital Yankton, SD outpatient | 1 | $19 | $19 | — | — | 2–20 | $19 – $19 |
| 15 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $220 | $220 | — | — | 2–20 | $220 – $220 |
| 16 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $20 | $20 | — | — | 2–20 | $20 – $20 |
| 17 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $20 | $20 | — | — | 2–20 | $20 – $20 |
| 18 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $22 | $22 | — | — | 2–20 | $22 – $22 |
| 19 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $22 | $22 | — | — | 2–20 | $22 – $22 |
| 20 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $10 | $10 | $5 | 53% | 2–20 | $5 – $16 |
| 21 | Platte Healthcare Platte, SD outpatient | 1 | $263 | $263 | — | — | 2–20 | $263 – $263 |
| 22 | Platte Healthcare Platte, SD percent of total billed charges · outpatientfrom % of charges | 1 | $263 | $263 | — | — | 2–20 | $263 – $263 |
| 23 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $56 | $56 | — | — | 1–10 | $56 – $56 |
| 24 | Pella Regional Health Center Pella, IA other · outpatient | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 25 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $118 | $118 | $3 | 3% | — | $115 – $121 |
← Payers reporting CPT 86665 · Snapshot 20261111T120946Z-9134e7f7