go back

Illinois 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
$22.42 / $50.71 / $78.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.07 / $22.16 / $45.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.71 / $119.24 / $344.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $17.98 / $20.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.24 / $63.97 / $120.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.40 / $31.96 / $50.12
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.98 / $45.26 / $69.81
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.89 / $33.89 / $33.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.37 / $35.46 / $39.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $16.61 / $26.07