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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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $43.65 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $22.91 / $67.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $25.12 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $251.19 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $26.30 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $48.98 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $25.12 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.91 / $40.74 / $323.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $21.88 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $31.62 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $31.62