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Michigan 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
$24.55 / $24.55 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $22.39 / $39.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $29.51 / $51.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $19.50 / $19.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $31.62 / $102.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $24.55 / $45.71
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $34.67 / $47.86
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $19.95 / $64.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $26.30 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $21.38 / $36.31