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Genetic Test for a Respiratory Bacterium

Illinois 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 $71 · 10th–90th $37$1740%5%10%10th90th$71Professionalmedian $29 · 10th–90th $19$560%10%20%10th90th$29$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
$37.15
Median
$70.79
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$30.20
Typical High
$57.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$17.38
Typical High
$52.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$95.50
Typical High
$363.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$23.99
Typical High
$26.92
Cigna
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$85.11
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$47.86
Typical High
$72.44
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$60.26
Typical High
$120.23
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
United
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$70.79
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$25.12
Typical High
$47.86