go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$20.89 / $23.99 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $204.17 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $44.67 / $64.57
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $26.30
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $36.31 / $70.79