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Direct Test For Pneumocystis Pneumonia

Rhode Island 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?

$12.59

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $12.59 for this service. The price depends on where it is billed: about $12.59 from a physician practice, and about $14.79 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.59$8.51 to $16.60
FacilityA hospital or hospital-owned outpatient department$14.79$14.45 to $16.22

How much rates vary

Facilitymedian $15 · 10th to 90th $14 to $36Professionalmedian $13 · 10th to 90th $7 to $20
$10$20$50facility $15professional $13

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$12.59
Typical High
$12.59
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$13.80
Median
$14.79
Typical High
$16.22
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$6.76
Median
$8.91
Typical High
$21.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$11.22
Median
$28.84
Typical High
$50.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$8.51
Median
$13.49
Typical High
$18.20
United
Setting
Facility
Modifier
None
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
United
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$12.59
Typical High
$19.95

Where Rhode Island 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.

Rhode Island· 22nd of 51

$12.59

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.