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Montana 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
Professional
Modifier
Low / Median / High Price
$561.96 / $3,142.08 / $3,142.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.56 / $830.72 / $2,785.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.81 / $708.56 / $708.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.56 / $830.72 / $2,785.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.79 / $439.79 / $708.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.24 / $205.24 / $488.66