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Genetic Test for a Specific Bacterium

Missouri 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?

$38.02

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $38.02 for this service. The price depends on where it is billed: about $33.88 from a physician practice, and about $47.86 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 7 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$33.88$20.89 to $50.12
FacilityA hospital or hospital-owned outpatient department$47.86$35.48 to $61.66

How much rates vary

Facilitymedian $48 · 10th to 90th $30 to $81Professionalmedian $34 · 10th to 90th $14 to $71
$20$50$100$200facility $48professional $34

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
$52.48
Typical High
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$38.02
Typical High
$70.79
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$17.38
Typical High
$17.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.45
Typical High
$63.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$51.29
Typical High
$91.20
BCBS
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$35.48
Typical High
$60.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$74.13
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$18.62
Typical High
$41.69
Medica
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$41.69
Typical High
$165.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$173.78
United
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$35.48
Typical High
$41.69
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$52.48

Where Missouri 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.

Missouri· 12th of 51

$38.02

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.