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South Carolina 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
$18.20 / $64.57 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $21.88 / $30.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $51.29 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $26.92 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $66.07 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $17.78 / $81.28
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $26.30 / $63.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $26.30 / $31.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $13.18 / $26.30