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Genetic Test for a Respiratory Bacterium

Florida rates for HCPCS 87486

A laboratory test that detects genetic material from a specific type of bacterium linked to respiratory tract infection, using a technique that amplifies small amounts of genetic material so the test can find even a low level of the organism. A sample is usually collected from the nose, throat, or lower airway. Results help identify this particular cause of a cough, chest infection, or pneumonia-like illness.

Facilitymedian $87 · 10th–90th $31$2240%5%10%10th90th$87Professionalmedian $30 · 10th–90th $23$560%10%20%10th90th$30$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$30.90
Median
$93.33
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$30.20
Typical High
$56.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
AvMed
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$35.48
Typical High
$41.69
AvMed
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$35.48
Typical High
$42.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$42.66
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$29.51
Typical High
$70.79
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$30.90
Typical High
$30.90
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$34.67
Molina
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$20.89
Typical High
$40.74
United
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$31.62
Typical High
$43.65
United
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$18.20
Typical High
$54.95
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$35.48