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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.

Rates data updated July 2026.

How much does Direct Test For Pneumocystis Pneumonia cost?

$8.91

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $8.91 for this service. The price depends on where it is billed: about $8.91 from a physician practice, and about $45.71 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$8.91$8.71 to $14.79
FacilityA hospital or hospital-owned outpatient department$45.71$8.32 to $81.28

How much rates vary

Facilitymedian $46 · 10th to 90th $7 to $83Professionalmedian $9 · 10th to 90th $7 to $47
$10$20$50$100facility $46professional $9

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$60.26
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$8.91
Typical High
$46.77
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$9.55
Typical High
$11.75
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$8.32
Typical High
$15.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$12.02
Typical High
$29.51
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$14.45
Typical High
$23.44
United
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.75
Typical High
$16.60
United
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$6.92
Typical High
$16.60
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$8.32
Typical High
$17.78

Where Maryland sits

The same service costs 2.5 times more in Hawaii than in Washington, DC. 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.

Maryland· 50th of 51

$8.91

HI $21.88DC $8.91

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.