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Genetic Test for a Specific Bacterium

Rhode Island 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?

$26.30

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $26.30 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $87.10 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 4 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$25.70$24.55 to $26.30
FacilityA hospital or hospital-owned outpatient department$87.10$41.69 to $158

How much rates vary

Facilitymedian $87 · 10th to 90th $41 to $158Professionalmedian $26 · 10th to 90th $25 to $32
$20$50$100$200facility $87professional $26

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
$74.13
Median
$147.91
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$25.70
Typical High
$29.51
BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$40.74
Typical High
$44.67
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$38.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$19.50
Typical High
$19.50
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$48.98
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$50.12

Where Rhode Island 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.

Rhode Island· 51st of 51

$26.30

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.