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Genetic Test for a Respiratory Bacterium

Kentucky 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?

$32.36

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $32.36 for this service. The price depends on where it is billed: about $30.90 from a physician practice, and about $35.48 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$30.90$20.89 to $48.98
FacilityA hospital or hospital-owned outpatient department$35.48$28.84 to $47.86

How much rates vary

Facilitymedian $35 · 10th to 90th $27 to $76Professionalmedian $31 · 10th to 90th $17 to $79
$20$50$100$200facility $35professional $31

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
$26.92
Median
$29.51
Typical High
$66.07
Aetna
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$29.51
Typical High
$50.12
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$21.88
Median
$35.48
Typical High
$37.15
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$17.38
Median
$28.84
Typical High
$48.98
CareSource
Setting
Facility
Modifier
None
Typical Low
$35.48
Median
$47.86
Typical High
$48.98
CareSource
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$45.71
Typical High
$57.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$27.54
Median
$75.86
Typical High
$83.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$21.88
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
None
Typical Low
$19.50
Median
$29.51
Typical High
$58.88
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
$13.18
Median
$14.13
Typical High
$17.38
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$5.25
Median
$5.62
Typical High
$7.08

Where Kentucky 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.

Kentucky· 36th of 51

$32.36

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.