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Utah 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 $98 · 10th–90th $18–$1290%20%10th90th$98Professionalmedian $20 · 10th–90th $18–$390%20%10th90th$20$10.0$20.0$50.0$100.0

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 / $97.72 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.95 / $38.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $27.54 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $30.90 / $52.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $117.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $25.70
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $26.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $22.91 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $31.62