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Genetic Test for a Specific Bacterium

Iowa rates for HCPCS 87563

A laboratory test that looks for the genetic material of one specific type of bacterium, using a technique that amplifies small amounts of genetic material so even a low level of the organism can be detected. A sample is collected from the site suspected of infection, such as urine, a swab, or another bodily specimen. Results help confirm or rule out infection by this particular organism.

Rates data updated July 2026.

How much does Genetic Test for a Specific Bacterium cost?

$40.74

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $40.74 for this service. The price depends on where it is billed: about $34.67 from a physician practice, and about $63.10 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 8 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$34.67$28.84 to $87.10
FacilityA hospital or hospital-owned outpatient department$63.10$45.71 to $85.11

How much rates vary

Facilitymedian $63 · 10th to 90th $35 to $102Professionalmedian $35 · 10th to 90th $23 to $214
$20$50$100$200facility $63professional $35

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
$35.48
Median
$66.07
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$33.88
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$66.07
Typical High
$83.18
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$61.66
Typical High
$138.04
Medica
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$41.69
Typical High
$93.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$35.48
Typical High
$141.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$46.77
Typical High
$141.25
Midlands
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$38.02
Typical High
$74.13
United
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$77.62
United
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$23.44
Typical High
$104.71
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48

Where Iowa sits

The same service costs 3.7 times more in West Virginia than in Rhode Island. 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· 10th of 51

$40.74

WV $97.72RI $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.