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
HC AB; HTLV-I
Waterloo, IA
See all hospitals reporting CPT 86687 →Price type
Allen Memorial Hospital Corporation’s median price of $10 is 13% below the median hospital's median price ($11), higher than 32% of the 1,789 hospitals reporting CPT 86687. 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, 20 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 hmo fee schedule · both | $5.45 | $5.45 | $5.45 – $5.45 |
| 2 | UnitedHealthcare ppo fee schedule · both | $5.45 | $5.45 | $5.45 – $5.45 |
| 3 | UnitedHealthcare hmo fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 4 | UnitedHealthcare ppo fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 5 | Wellmark commercial fee schedule · both | $9.09 | $9.09 | $9.09 – $9.09 |
| 6 | Wellmark hmo fee schedule · both | $9.09 | $9.09 | $9.09 – $9.09 |
| 7 | Wellmark ppo fee schedule · both | $9.09 | $9.09 | $9.09 – $9.09 |
| 8 | Aetna medicare advantage case rate · outpatient | $9.27 | $9.27 | $9.27 – $9.27 |
| 9 | Molina medicare advantage case rate · outpatient | $9.27 | $9.27 | $9.27 – $9.27 |
| 10 | Wellmark medicare advantage case rate · outpatient | $9.27 | $9.27 | $9.27 – $9.27 |
| 11 | Humana medicare advantage case rate · outpatient | $9.54 | $9.54 | $9.54 – $9.54 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $9.54 | $9.54 | $9.54 – $9.54 |
| 13 | Cigna commercial fee schedule · both | $11.82 | $11.82 | $11.82 – $11.82 |
| 14 | Aetna hmo fee schedule · outpatient | $15.45 | $15.45 | $15.45 – $15.45 |
| 15 | Aetna ppo fee schedule · outpatient | $15.45 | $15.45 | $15.45 – $15.45 |
| 16 | Aetna ppo fee schedule · both | $16.08 | $16.08 | $16.08 – $16.08 |
| 17 | Aetna hmo fee schedule · both | $16.40 | $16.40 | $16.40 – $16.40 |
| 18 | Medica commercial percent of total billed charges · outpatientfrom % of charges | $30.29 | $30.29 | $28.59 – $31.99 |
| 19 | Cigna commercial percent of total billed charges · inpatientfrom % of charges | $39.28 | $39.28 | $39.28 – $39.28 |
| 20 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $39.28 | $39.28 | $39.28 – $39.28 |
Last updated: Jan 28, 2026
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