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
70504-0126-02 - varicella zoster immune globulin 1
Wayne, IN
See all hospitals reporting CPT 90396 →Price type
St. Joseph Health System, LLC’s median price of $15.8k is 520% above the median hospital's median price ($2.6k), higher than 99% of the 1,369 hospitals reporting CPT 90396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 33 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 node uhc mcr adv facility · fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 2 | Aetna node aetna mcr adv facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 3 | Anthem anthem in healthsync facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 4 | Anthem anthem in hmo ppo trad facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 5 | Anthem anthem in marketplace stld facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 6 | Anthem node anthem in mcr adv facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 7 | Humana node humana mcr adv facility · fee schedule · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 8 | Optum node united optum va ccn facility · per diem · outpatient | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 9 | Anthem node anthem essentials marketplace facility · fee schedule · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 10 | Anthem anthem in work comp facility · other · outpatient | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 11 | Anthem anthem in ppo facility · fee schedule · outpatient | $6.3k | $6.3k | — | — | — | $6.3k – $6.3k |
| 12 | Cigna cigna hmo facility · percent of total billed charges · inpatientfrom % of charges | $10.2k | $10.2k | — | — | — | $10.2k – $10.2k |
| 13 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $10.2k | $10.2k | — | — | — | $10.2k – $10.2k |
| 14 | Cigna cigna ppo facility · percent of total billed charges · inpatientfrom % of charges | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 15 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 16 | Aetna aetna all facility · percent of total billed charges · inpatientfrom % of charges | $14.6k | $14.6k | — | — | — | $14.6k – $14.6k |
| 17 | Aetna aetna all facility · percent of total billed charges · outpatientfrom % of charges | $14.6k | $14.6k | — | — | — | $14.6k – $14.6k |
| 18 | UnitedHealthcare uhc apa facility · percent of total billed charges · outpatientfrom % of charges | $14.8k | $14.8k | — | — | — | $14.8k – $14.8k |
| 19 | UnitedHealthcare uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges | $15.8k | $15.8k | — | — | — | $15.8k – $15.8k |
| 20 | Aetna aetna itec facility · percent of total billed charges · inpatientfrom % of charges | $21.5k | $21.5k | — | — | — | $21.5k – $21.5k |
| 21 | Aetna aetna itec facility · percent of total billed charges · outpatientfrom % of charges | $21.5k | $21.5k | — | — | — | $21.5k – $21.5k |
| 22 | MultiPlan multiplan primary facility · percent of total billed charges · inpatientfrom % of charges | $21.8k | $21.8k | — | — | — | $21.8k – $21.8k |
| 23 | MultiPlan multiplan primary facility · percent of total billed charges · outpatientfrom % of charges | $21.8k | $21.8k | — | — | — | $21.8k – $21.8k |
| 24 | First Health first health facility · percent of total billed charges · inpatientfrom % of charges | $23.7k | $23.7k | — | — | — | $23.7k – $23.7k |
| 25 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $23.7k | $23.7k | — | — | — | $23.7k – $23.7k |
Last updated: Apr 1, 2026
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