go back

Genetic Test for a Specific Bacterium

Vermont 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 Vermont, July 2026.

Insurers have agreed to pay about $35.48 for this service. The price depends on where it is billed: about $35.48 from a physician practice, and about $155 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 5 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$35.48$24.55 to $36.31
FacilityA hospital or hospital-owned outpatient department$155$107 to $200

How much rates vary

Facilitymedian $155 · 10th to 90th $59 to $339Professionalmedian $35 · 10th to 90th $19 to $44
$20$50$100$200facility $155professional $35

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$35.48
Typical High
$43.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$154.88
Typical High
$173.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$199.53
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
United
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$40.74
Typical High
$77.62

Where Vermont 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.

Vermont· 24th 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.