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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)

Facilitymedian $36 · 10th–90th $25–$710%10%20%10th90th$36Professionalmedian $22 · 10th–90th $15–$520%10%20%10th90th$22$10.0$20.0$50.0$100.0$200.0$500.0

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
$25.12 / $43.65 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.88 / $50.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $25.12 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $251.19 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $26.30 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $22.39 / $97.72
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $40.74 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $21.88 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $31.62 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $35.48