go back

Irritable Bowel Syndrome Antibody Test

Pennsylvania rates for HCPCS 0164U

Helps tell whether a person's bowel symptoms are due to irritable bowel syndrome. It measures two antibodies in blood plasma, one against the bacterial toxin CdtB and one against vinculin, a protein in the gut wall, and interprets them against thresholds set for IBS.

Rates data updated July 2026.

How much does Irritable Bowel Syndrome Antibody Test cost?

$95.50

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $174 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$91.20$87.10 to $105
FacilityA hospital or hospital-owned outpatient department$174$112 to $251

How much rates vary

Facilitymedian $174 · 10th to 90th $95 to $380Professionalmedian $91 · 10th to 90th $59 to $112
$50$100$200facility $174professional $91

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$213.80
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$91.20
Typical High
$104.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$154.88
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$162.18
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$66.07
Typical High
$162.18
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$112.20
Typical High
$194.98
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$213.80
Typical High
$398.11
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$91.20
Typical High
$173.78
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$123.03
Typical High
$275.42
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$112.20
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$112.20
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$67.61
Typical High
$169.82

Where Pennsylvania sits

The same service costs 2.8 times more in South Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 28th of 51

$95.50

SD $186KY $67.61

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.