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New Hampshire 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 $93 · 10th–90th $45–$1660%10%20%10th90th$93Professionalmedian $26 · 10th–90th $17–$600%20%10th90th$26$10.0$20.0$50.0$100.0$200.0

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
$66.07 / $95.50 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.44 / $117.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.98 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $97.72 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $27.54 / $109.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $50.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $26.30 / $75.86