go back

Rotavirus Antigen Detection Test

Pennsylvania rates for HCPCS 87425

This laboratory test checks a stool sample for a specific viral protein to detect rotavirus, a common cause of diarrhea and vomiting, particularly in infants and young children. It gives a quick result rather than growing the virus in culture. It's typically ordered when a young child has symptoms suggesting a viral gut infection.

Rates data updated July 2026.

How much does Rotavirus Antigen Detection Test cost?

$21.88

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $21.88 for this service. The price depends on where it is billed: about $9.77 from a physician practice, and about $42.66 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 9 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$9.77$9.55 to $11.48
FacilityA hospital or hospital-owned outpatient department$42.66$19.95 to $50.12

How much rates vary

Facilitymedian $43 · 10th to 90th $10 to $74Professionalmedian $10 · 10th to 90th $9 to $79
$10$20$50$100facility $43professional $10

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
$10.23
Median
$47.86
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.77
Typical High
$79.43
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$10.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$18.62
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$15.14
Typical High
$28.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$5.62
Median
$12.02
Typical High
$17.38
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$12.30
Typical High
$20.89
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$40.74
Typical High
$70.79
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$7.24
Typical High
$8.91
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$36.31
Typical High
$74.13
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$10.23
Typical High
$35.48
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$50.12
Typical High
$104.71
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$12.02
Typical High
$15.85
United
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$12.02
Typical High
$14.45
United
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$9.33
Typical High
$19.50

Where Pennsylvania sits

The same service costs 3.2 times more in South Dakota 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.

Pennsylvania· 6th of 51

$21.88

SD $28.84DC $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.