Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PHENOTYPE DNA HIV W/CLT ADD
Orange, TX
See all hospitals reporting CPT 87904 →Price type
CHRISTUS Hospital - Orange’s median price of $27 is 8% below the median hospital's median price ($30), higher than 36% of the 1,733 hospitals reporting CPT 87904. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 24 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare all payer fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 2 | UnitedHealthcare hix fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Aetna mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 4 | Bcbs Tx mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 5 | Humana gold choice mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 6 | Molina medicare adv mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 7 | UnitedHealthcare mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 8 | WellCare mm fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 9 | UnitedHealthcare chip km fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 10 | UnitedHealthcare star kid km fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 11 | UnitedHealthcare star km fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 12 | UnitedHealthcare star plus km fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 13 | Molina chip km fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 14 | Molina star km fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 15 | Molina star plus km fee schedule · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 16 | Devoted mm fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 17 | Humana choicecare fee schedule · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 18 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $100 | $100 | — | — | — | $100 – $100 |
| 19 | Bcbs Tx heb fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 20 | Bcbs Tx hmo fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 21 | Cigna new business fee schedule · outpatient | $122 | $122 | — | — | — | $122 – $122 |
| 22 | Bcbs Tx ppo fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 23 | Bcbs Tx traditional fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 24 | Cigna ppo fee schedule · outpatient | $156 | $156 | — | — | — | $156 – $156 |
Last updated: Jan 13, 2026
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