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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
$26.30 / $50.12 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $22.39 / $50.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $107.15 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $17.78 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $60.26 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $31.62 / $53.70
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $45.71 / $93.33
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
$33.88 / $33.88 / $33.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $31.62 / $52.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $17.38 / $26.30