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Direct Test For Pneumocystis Pneumonia

Maryland 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.

Facilitymedian $49 · 10th–90th $8$850%20%10th90th$49Professionalmedian $9 · 10th–90th $6$150%20%10th90th$9$5.0$10.0$20.0$50.0$100.0

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
$45.71
Median
$60.26
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$8.91
Typical High
$14.79
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$9.55
Typical High
$10.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$8.32
Typical High
$15.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$11.48
Typical High
$29.51
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$13.80
Typical High
$23.44
United
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.62
Typical High
$9.12
United
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$6.76
Typical High
$16.22
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$8.32
Typical High
$17.78