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Alaska rates for HCPCS 87904

Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additional drug tested (List separately in addition to code for primary procedure)

Facilitymedian $48 · 10th–90th $26–$1860%20%10th90th$48Professionalmedian $25 · 10th–90th $18–$870%10%20%10th90th$25$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $186.21 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.99 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $41.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $117.49
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $26.30 / $87.10
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $169.82
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $63.10 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.30 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $36.31 / $79.43