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Gram Stain Microscopic Exam

New Jersey 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?

$6.92

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $6.92 for this service. The price depends on where it is billed: about $3.80 from a physician practice, and about $16.98 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$3.80$3.31 to $4.90
FacilityA hospital or hospital-owned outpatient department$16.98$8.32 to $39.81

How much rates vary

Facilitymedian $17 · 10th to 90th $5 to $110Professionalmedian $4 · 10th to 90th $3 to $8
$10$100$1K$10Kfacility $17professional $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
$5.01
Median
$16.98
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$3.80
Typical High
$8.32
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.63
Typical High
$2.95
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$48.98
Typical High
$5,128.61
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$9.33
Typical High
$19.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$4.27
Typical High
$11.75
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$2.14
Typical High
$4.79
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$3.80
Typical High
$4.79
United
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$4.27
Typical High
$8.91
United
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.57
Typical High
$6.31

Where New Jersey 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.

New Jersey· 28th of 51

$6.92

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.