go back

Missouri 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
$22.68 / $35.04 / $60.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.80 / $22.68 / $29.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $27.37 / $120.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.87 / $32.64 / $70.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.45 / $54.70 / $145.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.67 / $26.35 / $101.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.68 / $41.87 / $324.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $21.85 / $810.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.64 / $33.79