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
VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML INTRAMUSC SOLN [129296]
Arlington, TX
See all hospitals reporting CPT 90396 →Price type
AMH Cath Labs LLC’s median price of $3.4k is 34% above the median hospital's median price ($2.6k), higher than 63% of the 1,369 hospitals reporting CPT 90396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 33 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $641 | $641 | — | — | — | $641 – $641 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $641 | $641 | — | — | — | $641 – $641 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $673 | $673 | — | — | — | $673 – $673 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $692 | $692 | — | — | — | $692 – $692 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $705 | $705 | — | — | — | $705 – $705 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 7 | Humana medicare advantage case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 8 | Humana medicare advantage ppo case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 9 | Molina medicare advantage case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 11 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 12 | WellCare medicare advantage mmp case rate · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 13 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 14 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 15 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 16 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 17 | Blue Cross Blue Shield hmo fee schedule · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 18 | Blue Cross Blue Shield exchange fee schedule · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 19 | Blue Cross Blue Shield ppo fee schedule · outpatient | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 20 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 21 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 22 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 23 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 24 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 25 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
Last updated: Apr 21, 2026
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