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
RL-A-AB HERPES SIMP NSP 50772D
Phoenix, AZ
See all hospitals reporting CPT 86694 →Price type
Agh Laveen Llc’s median price of $15 is 32% below the median hospital's median price ($22), higher than 22% of the 2,259 hospitals reporting CPT 86694. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 17 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 2 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 3 | UnitedHealthcare commercial|options fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Humana medicare|all plans fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 5 | WellCare medicare|all plans fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 6 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 7 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 8 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 9 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $30 | $30 | — | — | — | $30 – $30 |
| 10 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $30 | $30 | — | — | — | $30 – $30 |
| 11 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $40 | $40 | — | — | — | $40 – $40 |
| 12 | Cigna commercial|all other plans fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 13 | Cigna commercial|ppo fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 14 | Aetna commercial|all other plans fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 15 | Aetna commercial|ppo fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 16 | MultiPlan commercial|all plans fee schedule · inpatient | $51 | $94 | $94 | 100% | — | $31 – $281 |
| 17 | MultiPlan commercial|all plans fee schedule · outpatient | $51 | $94 | $94 | 100% | — | $31 – $281 |
Last updated: Feb 28, 2026
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