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Nebraska 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
$52.48 / $107.15 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $23.99 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $251.19 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $40.74 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $51.29 / $63.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $52.48 / $323.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $812.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $66.07 / $66.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $66.07 / $66.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $23.44 / $52.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $15.49 / $52.48