go back

Iowa 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
$19.95 / $48.98 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $22.91 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $50.12 / $63.10
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $44.67 / $69.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $37.15 / $81.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $33.88 / $144.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $33.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $16.22 / $70.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $26.30