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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
$47.06 / $47.06 / $67.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.25 / $50.84 / $50.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.34 / $54.24 / $101.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.97 / $19.51 / $47.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.31 / $48.44 / $57.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $26.59 / $32.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.94 / $23.46 / $50.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.11 / $52.14 / $93.85
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.81 / $45.67 / $50.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.51 / $36.42