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New Mexico 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
$19.55 / $39.10 / $78.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.55 / $31.28 / $167.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.92 / $172.67 / $280.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.95 / $16.95 / $16.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.26 / $41.96 / $64.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.40 / $42.49 / $42.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.97 / $40.06 / $50.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.98 / $34.79 / $56.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.30 / $15.99