go back

Idaho 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
$46.77 / $46.77 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $20.89 / $50.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $53.70 / $93.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $26.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $53.70 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $19.50 / $47.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $46.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $27.54 / $41.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.05 / $22.39
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $52.48 / $93.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.39 / $27.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $36.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $36.31