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-RF HIVABDIF 2012669A
Folsom, CA
See all hospitals reporting CPT 86701 →Price type
Dignity Health’s median price of $20 is 26% above the median hospital's median price ($16), higher than 59% of the 2,403 hospitals reporting CPT 86701. 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, 36 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 | Anthem medicare|all other plans fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 2 | Aetna medicare|all plans fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Blue Cross Blue Shield medicare|hmo fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Blue Cross Blue Shield medicare|ppo fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Humana commercial|all plans fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 6 | Kaiser medicare|all plans fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 7 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 8 | Anthem medicare|imperial fee schedule · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 9 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 10 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 11 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 12 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 13 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 14 | Cigna commercial|localplus fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 15 | Molina medicaid|all plans fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 16 | Anthem medicaid|all plans fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 17 | Cigna commercial|all other plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 18 | Aetna commercial|all other plans fee schedule · outpatient | $43 | $43 | $18 | 42% | 2–20 | $25 – $61 |
| 19 | Aetna commercial|hmo fee schedule · outpatient | $43 | $43 | $18 | 42% | 2–20 | $25 – $61 |
| 20 | Aetna commercial|ppo fee schedule · outpatient | $43 | $43 | $18 | 42% | 2–20 | $25 – $61 |
| 21 | Anthem commercial|connection epo fee schedule · outpatient | $68 | $68 | $48 | 71% | — | $20 – $116 |
| 22 | Anthem commercial|all other plans fee schedule · outpatient | $85 | $85 | $60 | 71% | — | $25 – $145 |
| 23 | Anthem commercial|mcs fee schedule · outpatient | $114 | $114 | $89 | 78% | — | $25 – $203 |
| 24 | Kaiser medicaid|all plans fee schedule · outpatient | $117 | $117 | $107 | 91% | — | $10 – $224 |
| 25 | Blue Cross Blue Shield commercial|aco trio fee schedule · outpatient | $157 | $157 | $144 | 91% | — | $14 – $301 |
Last updated: Feb 28, 2026
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