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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 October 2026.

How much does Direct Test For Pneumocystis Pneumonia cost?

$14.45

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $14.45 for this service. The price depends on where it is billed: about $10.96 from a physician practice, and about $45.71 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$10.96$7.08 to $18.62
FacilityA hospital or hospital-owned outpatient department$45.71$17.78 to $81.28

How much rates vary

Facilitymedian $46 · 10th to 90th $11 to $100Professionalmedian $11 · 10th to 90th $5 to $26
$10$20$50$100facility $46professional $11

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
$8.91
Median
$38.90
Typical High
$39.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$6.46
Median
$10.96
Typical High
$14.45
BCBS New Mexico
Setting
Facility
Modifier
None
Typical Low
$17.78
Median
$64.57
Typical High
$100.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Cigna
Setting
Professional
Modifier
None
Typical Low
$8.91
Median
$18.62
Typical High
$30.20
Providence
Setting
Facility
Modifier
None
Typical Low
$7.76
Median
$15.14
Typical High
$23.44
Providence
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$21.88
Typical High
$30.20
United
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
United
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$7.08
Typical High
$7.41

Where New Mexico 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.

New Mexico· 15th of 51

$14.45

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.