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 HERPES SIMP VRL CLT PROG W/TYP
Hanover, PA
See all hospitals reporting CPT 87255 →Price type
UPMC Hanover’s median price of $60 is 48% above the median hospital's median price ($41), higher than 74% of the 2,168 hospitals reporting CPT 87255. 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, 20 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 commercial facility · fee schedule · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 2 | Highmark medicare facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 3 | Aetna aco facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 4 | Aetna commercial facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 5 | Humana medicare facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 6 | Aetna medicare facility · fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 7 | Cigna medicare facility · fee schedule · outpatient | $36 | $36 | — | — | — | $36 – $36 |
| 8 | UnitedHealthcare medicare facility · fee schedule · outpatient | $36 | $36 | — | — | — | $36 – $36 |
| 9 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $38 | $38 | — | — | — | $38 – $38 |
| 10 | UnitedHealthcare pa medicaid facility · fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 11 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $57 | $57 | $3 | 5% | — | $54 – $60 |
| 12 | Highmark medicaid facility · fee schedule · outpatient | $80 | $80 | $32 | 40% | — | $48 – $112 |
| 13 | Cigna commercial facility · fee schedule · outpatient | $88 | $88 | — | — | — | $88 – $88 |
| 14 | Highmark commercial facility · fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 15 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $204 | $204 | $10 | 5% | — | $194 – $214 |
| 16 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $204 | $204 | $10 | 5% | — | $194 – $214 |
| 17 | Carefirst commercial facility · percent of total billed charges · inpatientfrom % of charges | $255 | $255 | $13 | 5% | — | $242 – $268 |
| 18 | Carefirst commercial facility · percent of total billed charges · outpatientfrom % of charges | $255 | $255 | $13 | 5% | — | $242 – $268 |
| 19 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $255 | $255 | $13 | 5% | — | $242 – $268 |
| 20 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $255 | $255 | $13 | 5% | — | $242 – $268 |
Last updated: Mar 6, 2026
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