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Genetic Test for a Respiratory Bacterium

South Dakota 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 $66 · 10th–90th $40$1910%10%20%10th90th$66Professionalmedian $32 · 10th–90th $23$830%20%10th90th$32$20.0$50.0$100.0$200.0

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
$39.81
Median
$91.20
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$30.90
Typical High
$45.71
Avera
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$66.07
Typical High
$83.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$56.23
Typical High
$117.49
Medica
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$24.55
Typical High
$288.40
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$85.11
Typical High
$95.50
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$31.62
Typical High
$60.26
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48