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Direct Test For Pneumocystis Pneumonia

South Dakota 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.

Facilitymedian $23 · 10th–90th $12$230%50%10th$23Professionalmedian $20 · 10th–90th $8$320%10%10th90th$20$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$13.49
Typical High
$13.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$9.33
Typical High
$11.22
Avera
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$12.02
Typical High
$17.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$22.91
Typical High
$22.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$22.91
Typical High
$28.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$18.62
Typical High
$58.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$8.32
Typical High
$16.60
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$28.84
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$10.72
Typical High
$16.60
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02