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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
$18.25 / $20.32 / $123.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.32 / $20.32 / $22.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.50 / $54.44 / $93.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $26.07 / $34.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.39 / $75.59 / $158.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.15 / $18.32 / $98.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.32 / $26.07 / $125.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $14.34 / $14.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.65 / $13.46 / $23.74