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Genetic Test for a Respiratory Bacterium

Iowa 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.

Rates data updated October 2026.

How much does Genetic Test for a Respiratory Bacterium cost?

$41.69

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $41.69 for this service. The price depends on where it is billed: about $40.74 from a physician practice, and about $60.26 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$40.74$29.51 to $77.62
FacilityA hospital or hospital-owned outpatient department$60.26$41.69 to $89.13

How much rates vary

Facilitymedian $60 · 10th to 90th $35 to $110Professionalmedian $41 · 10th to 90th $21 to $138
$20$50$100$200facility $60professional $41

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$27.54
Median
$67.61
Typical High
$100.00
Aetna
Setting
Professional
Modifier
None
Typical Low
$23.44
Median
$27.54
Typical High
$46.77
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$66.07
Typical High
$109.65
Hally Health
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$61.66
Typical High
$93.33
Medica
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$60.26
Typical High
$109.65
Medica
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$54.95
Typical High
$288.40
Midlands
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$46.77
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$38.02
Typical High
$74.13
United
Setting
Facility
Modifier
None
Typical Low
$35.48
Median
$35.48
Typical High
$89.13
United
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$20.89
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$13.80
Median
$13.80
Typical High
$20.89
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$5.50
Median
$5.50
Typical High
$8.51

Where Iowa sits

The same service costs 3.0 times more in Alaska than in Maryland. 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.

Iowa· 18th of 51

$41.69

AK $79.43MD $26.30

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.