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Direct Test For Pneumocystis Pneumonia

Washington, DC 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?

$9.55

Typical negotiated rate. In Washington, DC, October 2026.

Insurers have agreed to pay about $9.55 for this service. Most negotiated rates run $8.71 to $15.49.

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 $20 · 10th to 90th $9 to $47Professionalmedian $10 · 10th to 90th $7 to $19
$10$20$50$100facility $20professional $10

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$8.91
Median
$8.91
Typical High
$8.91
Aetna
Setting
Professional
Modifier
None
Typical Low
$8.91
Median
$8.91
Typical High
$8.91
CareFirst
Setting
Professional
Modifier
None
Typical Low
$8.71
Median
$9.55
Typical High
$15.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$19.50
Median
$20.42
Typical High
$46.77
Cigna
Setting
Professional
Modifier
None
Typical Low
$6.46
Median
$13.49
Typical High
$89.13
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$23.44
Median
$23.44
Typical High
$25.12
United
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$7.59
Typical High
$18.62

Where Washington, DC 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.

Washington, DC· 46th of 51

$9.55

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.