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Maryland 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
Professional
Modifier
Low / Median / High Price
$19.29 / $19.55 / $24.26
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.46 / $26.07 / $38.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.35 / $20.50 / $64.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $32.59 / $49.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.47 / $15.64 / $22.94
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.04 / $25.58 / $25.58