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Genetic Test for a Specific Bacterium

New Jersey 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?

$32.36

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $32.36 for this service. The price depends on where it is billed: about $28.84 from a physician practice, and about $77.62 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$28.84$22.91 to $35.48
FacilityA hospital or hospital-owned outpatient department$77.62$45.71 to $151

How much rates vary

Facilitymedian $78 · 10th to 90th $26 to $257Professionalmedian $29 · 10th to 90th $19 to $36
$100$1K$10Kfacility $78professional $29

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
$25.12
Median
$72.44
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$28.84
Typical High
$36.31
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$93.33
Typical High
$2,691.53
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$35.48
Typical High
$47.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$77.62
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$39.81
Typical High
$107.15
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$37.15
Typical High
$66.07
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$10,471.29
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$35.48
United
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$35.48
Typical High
$72.44
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$38.90

Where New Jersey 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.

New Jersey· 41st of 51

$32.36

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.