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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)

Facilitymedian $56 · 10th–90th $23–$1230%10%20%10th90th$56Professionalmedian $21 · 10th–90th $15–$490%20%10th90th$21$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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
$30.90 / $79.43 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.88 / $48.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $64.57 / $120.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $23.44 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $39.81 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $23.44 / $43.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $31.62 / $190.55
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $26.30