go back

Massachusetts 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
$24.84 / $69.37 / $110.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.12 / $24.84 / $44.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.78 / $36.72 / $87.33
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $26.44 / $810.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.78 / $70.34 / $127.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.51 / $24.51 / $33.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.74 / $44.60 / $100.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.66 / $28.82 / $94.36
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.00 / $3,472.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.81 / $37.81 / $44.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $26.07 / $84.78
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.36 / $324.13 / $324.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $22.00 / $810.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $21.85 / $52.14