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Texas 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
$19.70 / $48.64 / $129.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.60 / $19.29 / $39.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.18 / $84.21 / $157.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $14.34 / $36.50
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.07 / $26.07 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.86 / $57.45 / $122.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.72 / $19.36 / $55.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.06 / $324.13 / $324.13
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$810.43 / $810.43 / $810.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.88 / $35.19 / $74.66
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.07 / $26.07 / $36.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.92 / $41.87 / $132.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.03 / $25.87 / $50.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.95 / $15.30 / $21.85
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.87 / $13.50 / $26.07