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South Dakota 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 $50 · 10th–90th $24–$500%50%10th$50Professionalmedian $26 · 10th–90th $18–$710%10%20%10th90th$26$10.0$20.0$50.0$100.0$200.0$500.0

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
$23.99 / $23.99 / $29.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $23.99 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $50.12 / $63.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $40.74 / $51.29
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $18.20 / $812.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $23.44 / $44.67
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $26.30