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Arizona 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $79.43 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $23.99 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $46.77 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $22.91 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $27.54 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $23.44 / $52.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $31.62 / $190.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.14 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $23.44 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.14 / $15.85