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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)

Facilitymedian $48 · 10th–90th $20–$1120%5%10th90th$48Professionalmedian $20 · 10th–90th $17–$400%20%40%10th90th$20$10.0$20.0$50.0$100.0$200.0

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
$18.20 / $64.57 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.95 / $39.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $53.70 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.30 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $16.98 / $81.28
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $25.12 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $26.30 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $13.49 / $28.84