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See a sample rate comparisonCPT 84206 Fee Schedule
Medicare rates as of January 2026
CPT 84206 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Digestive Enzyme Test, The Test Measures Proinsulin Made By The Pancreas To Help Digest Sugars. It Is Involved In The Conversion Of Glucose.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $26.69 national lab fee schedule rate (2026) · View Medicare rates for 84206 |
| Medicaid Fee Schedule | $24.555 median of the 8 states in the free preview · View Medicaid rates for 84206 |
National average reimbursement for CPT 84206 by major payers:
$20.99
BCBS / Anthem
$15.64
UnitedHealthcare
$26.75
Aetna
$38.96
Cigna
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CPT 84206
5 of 25 sample ratesHigher to lower in this preview
All Ways Homecare Inc
$60.00Published rateEmerus Bhs Sa Thousand Oaks LLC
$26.69Published ratePrisma Health-Upstate, Prisma Health Int Med/Subspec Clinic
Prisma Health - Upstate
$24.02Published rateChristopher Raio
St Joseph Hospital
$14.41Published rateMolly Mcintosh
Baycare Medical Group Inc
$7.71Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 84206 vs. Other Chemistry Procedures Codes
The table lists codes related to 84206. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 84206-CPT | Low | Digestive Enzyme Test, The Test Measures Proinsulin Made By The Pancreas To Help Digest Sugars. It Is Involved In The Conversion Of Glucose. |
| 84233-CPT | Low | Breast Cancer Therapy Test, The Test Checks How A Sample Of Tissue (Biopsy) Responds To Chemotherapy Or Hormone Therapy That Has Been Proposed To Treat Breast Cancer. |
| 84402-CPT | Low | Testosterone Hormone Test, Testosterone Helps Balance Male-Female Secondary Sex Characteristics Like Body Hair. Results Help Evaluate Pituitary Gland And Sex Gland Conditions. |
| 84410-CPT | Low | Testosterone; Bioavailable Direct Measurement (Eg Differential Precipitation). (Reinstated 01/01/2017). Thallium Blood Or Urine (Del 03/31/2003) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84206 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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