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Direct Test For Pneumocystis Pneumonia

Connecticut rates for HCPCS 87281

A laboratory test that looks directly for Pneumocystis, a fungus that causes serious pneumonia in people whose immune systems are weakened, in a sample of sputum or fluid washed from the lungs. Antibodies tagged with a fluorescent dye attach to the organism, making it visible under a special microscope. It gives a rapid answer because this organism cannot be grown in ordinary culture.

Rates data updated October 2026.

How much does Direct Test For Pneumocystis Pneumonia cost?

$10.96

Typical negotiated rate. In Connecticut, October 2026.

Insurers have agreed to pay about $10.96 for this service. Most negotiated rates run $7.24 to $16.98.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $17 · 10th to 90th $12 to $32Professionalmedian $8 · 10th to 90th $6 to $17
$10$20$50facility $17professional $8

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
$6.31
Median
$10.72
Typical High
$10.96
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$12.30
Median
$16.60
Typical High
$29.51
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$7.24
Typical High
$16.98
Cigna
Setting
Facility
Modifier
None
Typical Low
$7.94
Median
$19.05
Typical High
$44.67
Cigna
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$12.59
Typical High
$19.50
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$7.08
Median
$9.55
Typical High
$17.78
United
Setting
Professional
Modifier
None
Typical Low
$6.03
Median
$10.23
Typical High
$20.89
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
$4.79
Median
$5.37
Typical High
$5.37
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$1.95
Median
$2.14
Typical High
$2.14

Where Connecticut sits

The same service costs 4.5 times more in Kansas than in New Jersey. 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· 32nd of 51

$10.96

KS $38.02NJ $8.51

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.