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Oklahoma 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
$19.50 / $26.30 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $23.99 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $97.72 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $21.88 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $18.62 / $54.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $36.31 / $52.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.14 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $26.30 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $14.79 / $22.39