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Maine 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)

Facilitymedian $26 · 10th–90th $26–$2450%50%90th$26Professionalmedian $24 · 10th–90th $19–$320%20%10th90th$24$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $28.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $245.47 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $14.79 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $26.30 / $41.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $26.30 / $51.29