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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
$17.21 / $110.79 / $300.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.21 / $17.21 / $167.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.43 / $296.51 / $573.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.64 / $41.45 / $42.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.28 / $53.12 / $66.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.64 / $70.80 / $324.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.64 / $15.64 / $810.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.28 / $53.70 / $81.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.28 / $55.91 / $75.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.86 / $15.64 / $52.14