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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)

Facilitymedian $32 · 10th–90th $19–$1020%10%10th90th$32Professionalmedian $24 · 10th–90th $12–$410%10%20%10th90th$24$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$19.50 / $26.30 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $25.12 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $42.66 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $15.85 / $54.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $36.31 / $52.48
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $23.44 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $13.18 / $22.39