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Rhode Island 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
$42.66 / $77.62 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $23.99 / $117.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $31.62 / $35.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $19.50 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $79.43 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $20.42 / $56.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $21.88 / $51.29