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
HIV AG W/HIV1&2 ANTB W/OPTIC
Luling, TX
See all hospitals reporting CPT 87806 →Price type
Ascension Seton’s median price of $59 is 70% above the median hospital's median price ($35), higher than 78% of the 1,691 hospitals reporting CPT 87806. 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, 47 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 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 2 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 3 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 4 | Blue Cross Blue Shield 4170_blue cross chip (ebd) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 5 | Blue Cross Blue Shield 4170_blue cross chip/star kids (ebd) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 6 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 7 | Blue Cross Blue Shield 4221_chirp blue cross star (ebd) outpatient 20241201 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 8 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 9 | Blue Cross Blue Shield 5007_blue cross star kids (ebd) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 10 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 11 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 12 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 13 | Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 14 | UnitedHealthcare 4255_chirp uhc star (ebd) outpatient 20241201 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 15 | UnitedHealthcare 4266_chirp uhc star plus (ebd) outpatient 20241201 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 16 | UnitedHealthcare 4313_uhc star kids (ebd) outpatient 20241201 fee schedule · both | $28 | $28 | — | — | — | $28 – $28 |
| 17 | Humana 2668_humana hmo 20230701 other · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 18 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 19 | Blue Cross Blue Shield 3596_blue cross chip/star kids (ebd) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 20 | Blue Cross Blue Shield 3693_chirp blue cross star (chi,dcn) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 21 | Blue Cross Blue Shield 3695_chirp blue cross star (ebd) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 22 | UnitedHealthcare 3737_chirp uhc star (chi,dcn) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 23 | UnitedHealthcare 3739_chirp uhc star (ebd) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 24 | UnitedHealthcare 3748_chirp uhc star plus (chi,dcn) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 25 | UnitedHealthcare 3750_chirp uhc star plus (ebd) inpatient 20240901 fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
Last updated: Jan 1, 2026
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