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Direct Test For Pneumocystis Pneumonia

Kentucky 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 July 2026.

Facilitymedian $12 · 10th–90th $10$290%20%40%10th90th$12Professionalmedian $10 · 10th–90th $7$170%20%10th90th$10$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$28.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$9.77
Typical High
$51.29
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$12.02
Typical High
$12.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$10.00
Typical High
$16.60
CareSource
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$14.45
Typical High
$16.60
CareSource
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$15.14
Typical High
$23.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$25.70
Typical High
$25.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$81.28
Typical High
$81.28
United
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$12.02
Typical High
$16.60
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$9.55
Typical High
$16.60