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HIV Drug Resistance Sequencing

Vermont rates for HCPCS 0219U

Guides HIV treatment by sequencing three genes of the virus itself — protease, reverse transcriptase and integrase — to work out which antiviral drugs it is likely to resist. It reads the virus's genetic material, not the patient's own DNA.

Rates data updated July 2026.

How much does HIV Drug Resistance Sequencing cost?

$891

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $891 for this service. The price depends on where it is billed: about $891 from a physician practice, and about $1,096 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$891$513 to $891
FacilityA hospital or hospital-owned outpatient department$1,096$1,096 to $1,259

How much rates vary

Facilitymedian $1,096 · 10th to 90th $724 to $1,259Professionalmedian $891 · 10th to 90th $513 to $891
$500$1Kfacility $1,096professional $891

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$891.25
Typical High
$891.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,258.93
Typical High
$1,258.93
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$724.44
Typical High
$1,548.82

Where Vermont sits

The same service costs 5.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Vermont· 8th of 51

$891

AK $1,622KY $295

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.