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Genetic Test for a Specific Bacterium

West 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?

$97.72

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $28.18 from a physician practice, and about $129 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$28.18$26.30 to $29.51
FacilityA hospital or hospital-owned outpatient department$129$97.72 to $138

How much rates vary

Facilitymedian $129 · 10th to 90th $52 to $151Professionalmedian $28 · 10th to 90th $23 to $33
$20$50$100$200facility $129professional $28

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
$52.48
Median
$128.82
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$28.84
Typical High
$29.51
CareSource
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
CareSource
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$41.69
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$83.18
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$169.82
Typical High
$169.82
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$123.03
Typical High
$169.82
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
United
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$14.79
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$17.38
Typical High
$38.90

Where West 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.

West Virginia· 1st of 51

$97.72

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.