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Tennessee 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
$19.50 / $24.55 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $20.89 / $39.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $28.84 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $64.57 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $19.05 / $57.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $26.30 / $26.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $17.78 / $37.15