CPT 86704: Total Hepatitis B Core Antibody Immunoassay
Commercial payers pay $28 on average nationally for this procedure.
CPT code 86704 represents a laboratory immunoassay performed on a patient specimen, typically serum, to detect total hepatitis B core antibodies (total anti-HBc), reporting a combined result for all immunoglobulin classes; the service is a serologic infectious disease antibody test and the typical site of service is a clinical laboratory or hospital lab where diagnostic immunoassay testing is performed.
For related coverage guidance, see recent payer policy updates: Diagnosis of Idiopathic Environmental Intolerance, Allergen Testing, Allergen Testing.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 86704 centers on BUCA’s average of $28 as the market mid-line, with notable variation among major carriers. Blue Cross Blue Shield displays the highest central tendency at a $35.9 median and a wide spread, while Aetna and Cigna sit closer to BUCA on average ($13.4 and $13.2 respectively). UnitedHealth Group posts a lower median ($7.2) and mean ($10.6), indicating a cluster of lower rates relative to the overall commercial average.
Dispersion measured by the interquartile range (P75–P25) highlights where rates are tight or wide: Blue Cross Blue Shield’s IQR is $16.1 (wideest), BUCA’s IQR is $12.5 (moderately wide), Cigna’s IQR is $10.6, UnitedHealth Group’s IQR is $6.6, and Aetna’s IQR is $5.6 (tightest). This indicates Blue Cross Blue Shield and BUCA contribute most to market variability, while Aetna and UnitedHealth Group are relatively constrained.