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Genetic Test for a Specific Bacterium

Virginia 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 Virginia, July 2026.

Insurers have agreed to pay about $35.48 for this service. The price depends on where it is billed: about $26.30 from a physician practice, and about $53.70 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$26.30$18.62 to $32.36
FacilityA hospital or hospital-owned outpatient department$53.70$35.48 to $91.20

How much rates vary

Facilitymedian $54 · 10th to 90th $35 to $209Professionalmedian $26 · 10th to 90th $14 to $47
$20$100$500$2K$10Kfacility $54professional $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
$38.90
Median
$77.62
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$29.51
Typical High
$36.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$141.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$23.44
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$104.71
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$69.18
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$21.38
Typical High
$36.31
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$38.90
Typical High
$48.98
Medcost
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$35.48
Typical High
$60.26
Medcost
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$22.91
Typical High
$74.13
Sentara
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$41.69
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$41.69
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$35.48
Typical High
$41.69
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$18.20
Typical High
$45.71

Where Virginia 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.

Virginia· 21st 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.