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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
$27.63 / $35.92 / $127.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $31.54 / $40.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.29 / $52.11 / $483.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.77 / $28.68 / $45.85
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $26.07 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.16 / $71.95 / $161.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.25 / $29.90 / $67.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.64 / $44.00