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.
Generation details were not recorded for this description.
Original text from hospital filings
RL-A-HERPIICSF 50359
Glendale, CA
See all hospitals reporting CPT 86696 →Price type
Dignity Community Care’s median price of $17 is 44% below the median hospital's median price ($30), higher than 5% of the 2,602 hospitals reporting CPT 86696. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 30 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 commercial|exchange fee schedule · outpatient | $4 | $4 | $1 | 24% | — | $3 – $4 |
| 2 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $5 | $5 | $1 | 24% | — | $4 – $6 |
| 3 | Kaiser commercial|all plans fee schedule · inpatient | $10 | $10 | $2 | 24% | — | $8 – $12 |
| 4 | Kaiser commercial|all plans fee schedule · outpatient | $10 | $10 | $2 | 24% | — | $8 – $12 |
| 5 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $11 | $11 | $3 | 24% | — | $8 – $13 |
| 6 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $11 | $11 | $3 | 24% | — | $8 – $13 |
| 7 | First Health commercial|all plans fee schedule · inpatient | $12 | $12 | $3 | 24% | — | $9 – $14 |
| 8 | First Health commercial|all plans fee schedule · outpatient | $12 | $12 | $3 | 24% | — | $9 – $14 |
| 9 | MultiPlan commercial|all plans fee schedule · inpatient | $14 | $14 | $3 | 24% | — | $11 – $18 |
| 10 | MultiPlan commercial|all plans fee schedule · outpatient | $14 | $14 | $3 | 24% | — | $11 – $18 |
| 11 | Anthem commercial|non-mcs fee schedule · outpatient | $15 | $15 | $4 | 24% | — | $11 – $18 |
| 12 | Humana commercial|all plans fee schedule · outpatient | $16 | $16 | $3 | 18% | — | $14 – $19 |
| 13 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $16 | $16 | $3 | 18% | — | $14 – $19 |
| 14 | Anthem medicaid|all plans fee schedule · outpatient | $18 | $18 | $4 | 23% | — | $14 – $22 |
| 15 | Aetna commercial|all other plans fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 16 | Aetna commercial|hmo fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 17 | Aetna commercial|ppo fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 18 | Anthem commercial|mcs fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 19 | Molina medicaid|all plans fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 20 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 21 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 22 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 23 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $18 | $18 | $4 | 24% | — | $14 – $22 |
| 24 | Anthem medicare|alhambra senior fee schedule · outpatient | $19 | $19 | $3 | 18% | — | $16 – $22 |
| 25 | Anthem commercial|alhambra fee schedule · outpatient | $21 | $21 | $4 | 18% | — | $17 – $24 |
Last updated: Feb 28, 2026
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