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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)

Facilitymedian $52 · 10th–90th $20$1380%5%10%10th90th$52Professionalmedian $19 · 10th–90th $10$390%10%10th90th$19$2.0$10.0$50.0$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
$19.05 / $48.98 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.95 / $37.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $89.13 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $14.45 / $35.48
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $57.54 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $19.05 / $54.95
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $32.36 / $120.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $23.44 / $42.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $26.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $40.74 / $138.04
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $25.12 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $26.30 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.14 / $30.20
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $17.78 / $26.30