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Washington 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 $42 · 10th–90th $26–$1170%10%10th90th$42Professionalmedian $25 · 10th–90th $15–$650%20%10th90th$25$10.0$20.0$50.0$100.0$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
$26.30 / $57.54 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $23.99 / $50.12
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $38.90 / $52.48
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $26.30 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $57.54 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $27.54 / $35.48
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $37.15 / $81.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $38.02 / $81.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $27.54 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $52.48
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $28.84 / $31.62
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $45.71 / $81.28
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $31.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $69.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $26.30 / $33.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $31.62 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $15.49 / $31.62
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $26.30 / $46.77