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Direct Test For Pneumocystis Pneumonia

Wisconsin 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 $32 · 10th–90th $11$1070%10%10th90th$32Professionalmedian $14 · 10th–90th $6$490%10%20%10th90th$14$5.0$10.0$20.0$50.0$100.0

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
$17.78
Median
$69.18
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$14.45
Typical High
$46.77
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$32.36
Typical High
$33.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$47.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$9.12
Median
$9.12
Typical High
$9.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$34.67
Typical High
$54.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$18.20
Typical High
$37.15
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$26.30
Typical High
$95.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$11.22
Typical High
$61.66
Medica
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$10.00
Typical High
$26.92
Molina
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$33.11
Typical High
$64.57
Network Health
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$14.45
Typical High
$34.67
Network Health
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$19.50
Typical High
$33.88
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$10.72
Typical High
$15.49
Quartz
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$30.90
Typical High
$48.98
Quartz
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$70.79
Quartz
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$7.76
Typical High
$30.20
Security Health
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$25.70
Security Health
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$34.67
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$10.72
Typical High
$14.45
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$9.77
Typical High
$26.92