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Indiana 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
$21.38 / $29.98 / $96.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.60 / $21.38 / $24.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.60 / $24.84 / $78.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.87 / $12.87 / $18.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $33.89 / $36.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $31.28 / $39.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.92 / $26.07 / $67.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.48 / $32.60 / $283.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.64 / $32.14