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Pennsylvania 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 $69 · 10th–90th $25–$1150%20%10th90th$69Professionalmedian $21 · 10th–90th $19–$650%50%10th90th$21$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$24.55 / $70.79 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $77.62
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $181.97 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $41.69 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $28.18 / $58.88
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.44 / $35.48
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $26.30
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $41.69 / $83.18
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $69.18 / $89.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $39.81
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $25.70 / $26.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.70 / $26.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $42.66