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Maine rates for HCPCS 87903

Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $436.52 / $707.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $4,570.88 / $4,897.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $295.12 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $489.78 / $741.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $588.84
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $794.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $489.78 / $1,778.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $489.78 / $954.99