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
HC Lyme, Western B Lot
Utica, NY
See all hospitals reporting CPT 86617 →Price type
MVHS, Inc.’s median price of $15 is 39% below the median hospital's median price ($26), higher than 9% of the 2,548 hospitals reporting CPT 86617. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 29 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 excellus bcbs hmo/ppo fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 2 | Excellus excellus bcbs hmo/ppo fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 3 | Excellus excellus bcbs medicaid fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 4 | Excellus excellus bcbs medicaid hmo fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 5 | Excellus excellus bcbs medicare advantage fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 6 | Humana humana medicare advantage fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 7 | Medicare medicare fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 8 | Molina misc medicaid mco fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 9 | Optum vaccn optum fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 10 | UnitedHealthcare uhc essential plan fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 11 | UnitedHealthcare uhc medicaid fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 12 | WellCare hb mvhs wellcare medicaid fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 13 | UnitedHealthcare uhc medicare advantage fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 14 | Aetna aetna medicare advantage fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 15 | Humana humana military fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 16 | Tricare humana military fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 17 | WellCare wellcare medicare advantage fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 18 | UnitedHealthcare uhc commercial fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 19 | UnitedHealthcare uhc empire plan fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 20 | Cigna mvp and cigna commercial fee schedule · outpatient | $45 | $45 | — | — | — | $45 – $45 |
| 21 | Excellus excellus bcbs medicaid percent of total billed charges · inpatientfrom % of charges | $53 | $47 | $21 | 45% | — | $19 – $70 |
| 22 | Aetna aetna commercial percent of total billed charges · bothfrom % of charges | $119 | $107 | $48 | 45% | — | $43 – $158 |
| 23 | Humana humana hmo/pos percent of total billed charges · inpatientfrom % of charges | $130 | $116 | $52 | 45% | — | $47 – $172 |
| 24 | Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $136 | $122 | $55 | 45% | 3–30 | $49 – $180 |
| 25 | Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · inpatientfrom % of charges | $136 | $122 | $55 | 45% | — | $49 – $180 |
Last updated: Aug 7, 2026
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