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Direct Test For Pneumocystis Pneumonia

New Mexico 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?

$14.45

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $14.45 for this service. The price depends on where it is billed: about $8.91 from a physician practice, and about $38.90 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 5 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$8.91 to $14.45
FacilityA hospital or hospital-owned outpatient department$38.90$17.78 to $85.11

How much rates vary

Facilitymedian $39 · 10th to 90th $11 to $102Professionalmedian $9 · 10th to 90th $7 to $79
$10$100$1K$10K$100Kfacility $39professional $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
$17.78
Median
$36.31
Typical High
$38.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$10.96
Typical High
$79.43
BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$66.07
Typical High
$107.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$16.98
Typical High
$26.30
Providence
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$14.45
Typical High
$20.89
Providence
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$18.62
Typical High
$30.20
United
Setting
Facility
Modifier
Global
Typical Low
$4.57
Median
$10.72
Typical High
$17.78
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.08
Typical High
$8.91

Where New Mexico 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.

New Mexico· 14th of 51

$14.45

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.