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 EBV EARLY AG D AB (IGG)
Lititz, PA
See all hospitals reporting CPT 86663 →Price type
UPMC Lititz’s median price of $46 is 126% above the median hospital's median price ($20), higher than 76% of the 2,459 hospitals reporting CPT 86663. 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, 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 | Highmark medicare facility · fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 2 | Aetna medicare facility · fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 3 | Cigna medicare facility · fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $14 | $14 | — | — | — | $14 – $14 |
| 5 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 6 | UnitedHealthcare commercial facility · fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 7 | UnitedHealthcare pa medicaid facility · fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 8 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $25 | $25 | — | — | — | $25 – $25 |
| 9 | Highmark medicaid facility · fee schedule · outpatient | $32 | $32 | $9 | 27% | — | $23 – $40 |
| 10 | Cigna commercial facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 11 | Highmark commercial - children's health insurance facility · fee schedule · outpatient | $39 | $39 | — | — | — | $39 – $39 |
| 12 | Highmark commercial facility · fee schedule · outpatient | $41 | $41 | — | — | — | $41 – $41 |
| 13 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $46 | $46 | — | — | — | $46 – $46 |
| 14 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $48 | $48 | — | — | — | $48 – $48 |
| 15 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $55 | $55 | — | — | — | $55 – $55 |
| 16 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 17 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 18 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 19 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $105 | $105 | — | — | — | $105 – $105 |
| 20 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $105 | $105 | — | — | — | $105 – $105 |
Last updated: Mar 6, 2026
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