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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
$19.05 / $23.99 / $74.13
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $20.89 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $20.42 / $52.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $31.62 / $50.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $19.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $23.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $25.70 / $25.70