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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
$23.76 / $52.14 / $104.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.47 / $20.96 / $167.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.86 / $60.23 / $95.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.10 / $21.96 / $106.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.70 / $45.77 / $76.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.21 / $23.55 / $41.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.22 / $31.28 / $191.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.30 / $810.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $14.94 / $15.99