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Ohio 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 $35 · 10th–90th $21–$650%10%10th90th$35Professionalmedian $21 · 10th–90th $14–$410%20%10th90th$21$5.0$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
$20.89 / $39.81 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $21.88 / $40.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $27.54 / $47.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.60 / $35.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $34.67 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $25.70 / $61.66
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $28.84 / $104.71
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $25.70 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $23.44 / $32.36
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $31.62 / $58.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $31.62 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $36.31