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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
$24.77 / $24.77 / $38.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.42 / $24.77 / $24.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.27 / $29.74 / $51.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.57 / $19.55 / $20.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.28 / $21.31 / $58.66
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.53 / $24.77 / $45.51
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.46 / $34.70 / $39.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.58 / $23.73 / $38.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $20.89 / $35.56