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Gram Stain Microscopic Exam

Illinois 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 July 2026.

How much does Gram Stain Microscopic Exam cost?

$11.22

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $11.22 for this service. The price depends on where it is billed: about $4.27 from a physician practice, and about $40.74 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 7 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$4.27$3.47 to $5.62
FacilityA hospital or hospital-owned outpatient department$40.74$8.71 to $72.44

How much rates vary

Facilitymedian $41 · 10th to 90th $6 to $98Professionalmedian $4 · 10th to 90th $3 to $9
$5$10$20$50$100facility $41professional $4

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
$6.17
Median
$42.66
Typical High
$97.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$4.27
Typical High
$8.71
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.63
Typical High
$5.75
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$15.85
Typical High
$51.29
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$3.63
Typical High
$4.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$9.77
Typical High
$19.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$5.01
Typical High
$7.59
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$8.51
Typical High
$100.00
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$2.34
Typical High
$2.34
United
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$4.27
Typical High
$8.51
United
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$3.16
Typical High
$5.01

Where Illinois sits

The same service costs 11.7 times more in Maryland than in Wyoming. 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.

Illinois· 13th of 51

$11.22

MD $50.12WY $4.27

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.