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Gram Stain Microscopic Exam

Connecticut rates for HCPCS 87205

This laboratory test applies a special dye to a sample and examines it under a microscope to identify the general type of bacteria, fungi, or cells present. It gives quick, preliminary information about a possible infection, often before slower culture results are available.

Rates data updated October 2026.

How much does Gram Stain Microscopic Exam cost?

$4.27

Typical negotiated rate. In Connecticut, October 2026.

Insurers have agreed to pay about $4.27 for this service. The price depends on where it is billed: about $2.95 from a physician practice, and about $6.03 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.95$2.19 to $4.68
FacilityA hospital or hospital-owned outpatient department$6.03$5.01 to $9.55

How much rates vary

Facilitymedian $6 · 10th to 90th $4 to $13Professionalmedian $3 · 10th to 90th $2 to $6
$2$5$10$20facility $6professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.24
Median
$3.89
Typical High
$5.13
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$4.37
Median
$5.89
Typical High
$10.47
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$2.09
Median
$2.57
Typical High
$6.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.82
Median
$6.76
Typical High
$15.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.82
Median
$5.01
Typical High
$6.76
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$3.39
Typical High
$6.17
Health New England
Setting
Facility
Modifier
None
Typical Low
$11.48
Median
$23.44
Typical High
$35.48
United
Setting
Facility
Modifier
None
Typical Low
$1.38
Median
$1.38
Typical High
$12.02
United
Setting
Professional
Modifier
None
Typical Low
$2.14
Median
$3.16
Typical High
$7.41
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.74
Median
$1.95
Typical High
$1.95
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.69
Median
$0.78
Typical High
$0.78

Where Connecticut sits

The same service costs 24.0 times more in Vermont than in Georgia. 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.

Connecticut· 31st of 51

$4.27

VT $75.86GA $3.16

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.