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Genetic Test for a Respiratory Bacterium

North Carolina 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 July 2026.

How much does Genetic Test for a Respiratory Bacterium cost?

$43.65

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $43.65 for this service. The price depends on where it is billed: about $36.31 from a physician practice, and about $97.72 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 6 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$36.31$28.18 to $46.77
FacilityA hospital or hospital-owned outpatient department$97.72$45.71 to $135

How much rates vary

Facilitymedian $98 · 10th to 90th $30 to $240Professionalmedian $36 · 10th to 90th $26 to $56
$20$50$100$200facility $98professional $36

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
$30.20
Median
$107.15
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$41.69
Typical High
$56.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$107.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$34.67
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$75.86
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$25.70
Typical High
$58.88
Medcost
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Medcost
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$46.77
Typical High
$85.11
Medcost
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$45.71
Typical High
$66.07
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$48.98
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$309.03
Typical High
$309.03

Where North Carolina sits

The same service costs 2.5 times more in Alaska 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.

North Carolina· 16th of 51

$43.65

AK $69.18DC $27.54

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.