go back

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 October 2026.

How much does Gram Stain Microscopic Exam cost?

$4.27

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $4.27 for this service. The price depends on where it is billed: about $3.47 from a physician practice, and about $9.55 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.47$3.31 to $4.27
FacilityA hospital or hospital-owned outpatient department$9.55$5.75 to $16.22

How much rates vary

Facilitymedian $10 · 10th to 90th $4 to $30Professionalmedian $3 · 10th to 90th $3 to $6
$2$5$10$20$50facility $10professional $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
Facility
Modifier
None
Typical Low
$3.63
Median
$6.03
Typical High
$12.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.47
Median
$3.63
Typical High
$6.61
Ambetter
Setting
Professional
Modifier
None
Typical Low
$5.75
Median
$5.75
Typical High
$6.46
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$5.75
Median
$14.45
Typical High
$51.29
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$3.31
Median
$3.47
Typical High
$4.27
Cigna
Setting
Facility
Modifier
None
Typical Low
$4.79
Median
$9.77
Typical High
$17.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.19
Median
$5.01
Typical High
$7.76
Hally Health
Setting
Professional
Modifier
None
Typical Low
$4.47
Median
$7.41
Typical High
$69.18
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Molina
Setting
Professional
Modifier
None
Typical Low
$2.34
Median
$2.34
Typical High
$5.37
United
Setting
Facility
Modifier
None
Typical Low
$4.27
Median
$5.13
Typical High
$10.96
United
Setting
Professional
Modifier
None
Typical Low
$1.78
Median
$3.16
Typical High
$4.57
4 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
Facility
Modifier
52 · Reduced service
Typical Low
$1.74
Median
$3.09
Typical High
$6.46
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$0.71
Median
$1.23
Typical High
$2.57
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.74
Median
$1.74
Typical High
$2.14
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.71
Median
$0.71
Typical High
$0.85

Where Illinois 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.

Illinois· 34th 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.