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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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.86 / $54.44 / $80.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.86 / $20.86 / $37.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.02 / $28.16 / $46.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.87 / $16.07 / $38.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $32.59 / $39.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.89 / $35.19 / $62.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.83 / $32.88 / $148.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.21 / $23.55 / $61.61
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.83 / $32.88 / $148.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.21 / $23.55 / $62.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.52 / $23.46 / $32.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.64 / $36.42