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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)

Facilitymedian $204 · 10th–90th $26–$4680%20%10th90th$204Professionalmedian $31 · 10th–90th $24–$450%20%10th90th$31$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $26.30 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $38.02 / $64.57
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $26.30
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $36.31 / $70.79