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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)

Facilitymedian $107 · 10th–90th $17–$3160%10%10th90th$107Professionalmedian $21 · 10th–90th $15–$1740%10%20%10th90th$21$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
$52.48 / $107.15 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $21.38 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $251.19 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $40.74 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $53.70 / $63.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $52.48 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $812.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $15.49 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $15.49 / $74.13