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
HTLV-I ANTIBODY
San Antonio, TX
See all hospitals reporting CPT 86687 →Price type
Santa Rosa Emergency Center - Alon’s median price of $9 is 17% below the median hospital's median price ($11), higher than 6% of the 1,789 hospitals reporting CPT 86687. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 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 | UnitedHealthcare all payer fee schedule · outpatient | $5.06 | $5.06 | $5.06 – $5.06 |
| 2 | UnitedHealthcare chip km fee schedule · outpatient | $7.83 | $7.83 | $7.83 – $7.83 |
| 3 | UnitedHealthcare star km fee schedule · outpatient | $7.83 | $7.83 | $7.83 – $7.83 |
| 4 | UnitedHealthcare star plus km fee schedule · outpatient | $7.83 | $7.83 | $7.83 – $7.83 |
| 5 | Aetna chip km fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 6 | Aetna mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 7 | Aetna star km fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 8 | Bcbs Tx mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 9 | Bcbs Tx star chip km fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 10 | Humana gold choice mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 11 | Humana gold plus mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 12 | Molina chip km fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 13 | Molina medicare adv mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 14 | Molina star plus km fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 15 | UnitedHealthcare mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 16 | WellCare mm fee schedule · outpatient | $9.09 | $9.09 | $9.09 – $9.09 |
| 17 | Devoted mm fee schedule · outpatient | $9.82 | $9.82 | $9.82 – $9.82 |
| 18 | Aetna new business fee schedule · outpatient | $16.20 | $16.20 | $16.20 – $16.20 |
| 19 | Aetna epo fee schedule · outpatient | $18.00 | $18.00 | $18.00 – $18.00 |
| 20 | Aetna hmo fee schedule · outpatient | $18.00 | $18.00 | $18.00 – $18.00 |
| 21 | Aetna pos fee schedule · outpatient | $18.00 | $18.00 | $18.00 – $18.00 |
| 22 | Aetna ppo fee schedule · outpatient | $18.00 | $18.00 | $18.00 – $18.00 |
| 23 | Humana choicecare fee schedule · outpatient | $22.10 | $22.10 | $22.10 – $22.10 |
| 24 | Bcbs Tx blue advantangehmo fee schedule · outpatient | $23.36 | $23.36 | $23.36 – $23.36 |
| 25 | Bcbs Tx hmo fee schedule · outpatient | $28.45 | $28.45 | $28.45 – $28.45 |
Last updated: Jan 13, 2026
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