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
S/O CMV IGM AB
Gilbert, AZ
See all hospitals reporting CPT 86645 →Price type
Dignity Health’s median price of $28 is 7% above the median hospital's median price ($26), higher than 53% of the 2,558 hospitals reporting CPT 86645. 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, 26 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 | Aetna medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 2 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 3 | Cigna medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 4 | First Health medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 5 | Humana medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 6 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 7 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $17 | $17 | — | — | — | $17 – $17 |
| 8 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $20 | $20 | — | — | 2–20 | $20 – $20 |
| 9 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 10 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 11 | Cigna commercial|exchange fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 12 | Cigna commercial|localplus surefit fee schedule · outpatient | $37 | $37 | — | — | 2–20 | $37 – $37 |
| 13 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 14 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 15 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $46 | $46 | $37 | 80% | — | $9 – $83 |
| 16 | Cigna commercial|all other plans fee schedule · outpatient | $49 | $49 | — | — | — | $49 – $49 |
| 17 | Cigna commercial|ppo fee schedule · outpatient | $49 | $49 | — | — | — | $49 – $49 |
| 18 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 19 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $76 | $76 | $9 | 12% | — | $67 – $85 |
| 20 | Aetna commercial|all other plans fee schedule · outpatient | $76 | $76 | $9 | 12% | — | $67 – $86 |
| 21 | Aetna commercial|hmo fee schedule · outpatient | $76 | $76 | $9 | 12% | — | $67 – $86 |
| 22 | Aetna commercial|ppo fee schedule · outpatient | $76 | $76 | $9 | 12% | — | $67 – $86 |
| 23 | First Health commercial|all plans fee schedule · inpatient | $179 | $179 | $142 | 80% | — | $36 – $321 |
| 24 | First Health commercial|all plans fee schedule · outpatient | $179 | $179 | $142 | 80% | — | $36 – $321 |
| 25 | MultiPlan commercial|all plans fee schedule · inpatient | $255 | $255 | $203 | 80% | — | $52 – $457 |
Last updated: Feb 28, 2026
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