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Louisiana 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
$27.54 / $36.31 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $23.99 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $52.48 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $28.84 / $43.65
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $72.44 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $19.50 / $56.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $26.30 / $33.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $46.77