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Direct Test For Pneumocystis Pneumonia

Oklahoma 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?

$20.89

Typical negotiated rate. In Oklahoma, July 2026.

Insurers have agreed to pay about $20.89 for this service. The price depends on where it is billed: about $8.91 from a physician practice, and about $24.55 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$6.61 to $10.23
FacilityA hospital or hospital-owned outpatient department$24.55$12.02 to $35.48

How much rates vary

Facilitymedian $25 · 10th to 90th $9 to $42Professionalmedian $9 · 10th to 90th $5 to $14
$10$20$50$100facility $25professional $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
$8.91
Median
$13.18
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$8.91
Typical High
$13.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$28.84
Typical High
$40.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$12.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$18.20
Typical High
$32.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$7.24
Typical High
$16.98
Medica
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$12.02
Typical High
$70.79
Medica
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$6.92
Typical High
$15.85
United
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$12.02
Typical High
$15.85
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$6.92
Typical High
$10.23

Where Oklahoma 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.

Oklahoma· 2nd of 51

$20.89

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.