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Genetic Test for a Specific Bacterium

North Carolina 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?

$46.77

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $46.77 for this service. The price depends on where it is billed: about $29.51 from a physician practice, and about $81.28 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$29.51$28.18 to $45.71
FacilityA hospital or hospital-owned outpatient department$81.28$48.98 to $107

How much rates vary

Facilitymedian $81 · 10th to 90th $30 to $151Professionalmedian $30 · 10th to 90th $23 to $68
$20$50$100$200$500$1K$2Kfacility $81professional $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
$30.90
Median
$81.28
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.84
Typical High
$64.57
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$23.44
Typical High
$35.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$93.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$29.51
Typical High
$75.86
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
$16.60
Typical High
$47.86
Medcost
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$31.62
Typical High
$51.29
Medcost
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$22.91
Typical High
$31.62
United
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$41.69
Typical High
$42.66
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$56.23
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$263.03

Where North Carolina 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.

North Carolina· 7th of 51

$46.77

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.