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Direct Test For Pneumocystis Pneumonia

Kansas 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?

$38.02

Typical negotiated rate. In Kansas, October 2026.

Insurers have agreed to pay about $38.02 for this service. The price depends on where it is billed: about $12.02 from a physician practice, and about $40.74 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.02$7.24 to $23.99
FacilityA hospital or hospital-owned outpatient department$40.74$38.90 to $57.54

How much rates vary

Facilitymedian $41 · 10th to 90th $20 to $60Professionalmedian $12 · 10th to 90th $7 to $25
$10$20$50facility $41professional $12

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
$12.02
Median
$26.30
Typical High
$38.02
Aetna
Setting
Professional
Modifier
None
Typical Low
$8.91
Median
$12.02
Typical High
$12.59
BCBS Kansas
Setting
Facility
Modifier
None
Typical Low
$38.90
Median
$40.74
Typical High
$60.26
BCBS Kansas
Setting
Professional
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.32
Median
$15.49
Typical High
$27.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$7.24
Median
$31.62
Typical High
$40.74
Medica
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$19.95
Typical High
$36.31
Medica
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$7.24
Typical High
$22.39
United
Setting
Facility
Modifier
None
Typical Low
$7.24
Median
$7.24
Typical High
$12.02
United
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$7.24
Typical High
$25.12
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
$5.13
Median
$6.03
Typical High
$6.31
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.04
Median
$2.40
Typical High
$2.51

Where Kansas 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.

Kansas· 1st of 51

$38.02

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.