go back

Genetic Test for a Specific Bacterium

Illinois 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?

$35.48

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $35.48 for this service. The price depends on where it is billed: about $30.20 from a physician practice, and about $67.61 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$30.20$22.91 to $35.48
FacilityA hospital or hospital-owned outpatient department$67.61$43.65 to $120

How much rates vary

Facilitymedian $68 · 10th to 90th $35 to $200Professionalmedian $30 · 10th to 90th $3 to $54
$5$10$20$50$100$200facility $68professional $30

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
$34.67
Median
$70.79
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$29.51
Typical High
$51.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$17.38
Typical High
$52.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$75.86
Typical High
$371.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$23.99
Typical High
$35.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$67.61
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$42.66
Typical High
$58.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$63.10
Typical High
$194.98
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
$23.44
Typical High
$100.00

Where Illinois 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.

Illinois· 30th of 51

$35.48

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.