| Code | Description | States | Median rate |
|---|---|---|---|
| 87015 | Specimen concentration for infection testing | 47 | $6.51 |
| 87040 | Blood culture, bacterial | 46 | $10.09 |
| 87045 | Stool culture for Salmonella and Shigella | 45 | $9.19 |
| 87046 | Stool culture, additional pathogens, each plate | 46 | $8.36 |
| 87070 | Bacterial culture, other source | 46 | $8.38 |
| 87071 | Quantitative aerobic bacterial culture | 45 | $8.72 |
| 87073 | Quantitative anaerobic bacterial culture | 45 | $8.52 |
| 87075 | Anaerobic bacterial culture | 47 | $9.22 |
| 87076 | Anaerobic culture identification, each isolate | 46 | $7.92 |
| 87077 | Aerobic culture identification, each isolate | 45 | $7.72 |
| 87081 | Screening culture for specific organisms | 47 | $5.97 |
| 87084 | Screening culture with colony estimate | 44 | $21.66 |
| 87086 | Urine culture, quantitative | 46 | $7.89 |
| 87088 | Urine culture with identification of each organism | 46 | $7.97 |
| 87101 | Fungal culture, skin, hair or nail | 46 | $7.44 |
| 87102 | Fungal culture, other source | 46 | $8.22 |
| 87103 | Fungal blood culture | 45 | $16.94 |
| 87106 | Yeast culture identification, each | 45 | $10.11 |
| 87107 | Mold culture identification, each | 45 | $10.32 |
| 87109 | Mycoplasma culture | 46 | $13.85 |
| 87110 | Chlamydia culture | 46 | $19.16 |
| 87116 | Tuberculosis (acid-fast) culture | 45 | $10.50 |
| 87118 | Mycobacteria culture identification, each isolate | 44 | $13.15 |
| 87140 | Culture typing by immunofluorescence, each | 46 | $5.38 |
| 87143 | Culture typing by chromatography | 46 | $11.62 |
| 87147 | Culture typing by agglutination, each antiserum | 46 | $4.80 |
| 87149 | Culture identification by DNA probe, each organism | 46 | $20.05 |
| 87150 | Culture identification by amplified DNA probe, each | 44 | $33.86 |
| 87152 | Culture typing by pulsed field gel | 46 | $6.58 |
| 87153 | Culture identification by DNA sequencing, each isolate | 40 | $112.48 |
| 87158 | Culture typing, other method | 46 | $6.58 |
| 87164 | Dark field microscopy for syphilis | 47 | $10.36 |
| 87166 | Dark field microscopy, no collection | 46 | $10.17 |
| 87168 | Insect or tick identification | 45 | $4.18 |
| 87169 | Parasite identification, macroscopic | 45 | $4.22 |
| 87172 | Pinworm tape test | 44 | $4.23 |
| 87176 | Tissue homogenization for culture | 45 | $5.76 |
| 87177 | Ova and parasite stool exam | 46 | $8.45 |
| 87181 | Antibiotic susceptibility, agar dilution, per agent | 45 | $4.74 |
| 87184 | Antibiotic susceptibility, disk method, per plate | 45 | $7.28 |
| 87185 | Antibiotic resistance enzyme test, per enzyme | 45 | $4.63 |
| 87186 | Antibiotic susceptibility testing, per panel | 45 | $8.42 |
| 87187 | Antibiotic minimum lethal concentration test, per plate | 43 | $32.14 |
| 87188 | Antibiotic susceptibility, macrobroth dilution, per agent | 45 | $6.46 |
| 87190 | TB drug susceptibility, per agent | 45 | $6.58 |
| 87197 | Serum bactericidal titer (Schlichter) | 44 | $14.54 |
| 87205 | Gram stain smear | 47 | $4.17 |
| 87206 | Fluorescent or acid-fast stain smear | 47 | $5.20 |
| 87207 | Special stain smear for parasites or inclusion bodies | 47 | $5.99 |
| 87209 | Special stain smear for ova and parasites | 46 | $17.55 |
| 87210 | Wet mount microscopy | 47 | $5.16 |
| 87220 | KOH prep for fungus or scabies | 46 | $4.16 |
| 87230 | Toxin assay by tissue culture (C. difficile) | 46 | $19.50 |
| 87250 | Virus isolation in eggs or animals | 47 | $18.88 |
| 87252 | Virus culture with presumptive identification | 46 | $24.88 |
| 87253 | Virus culture, additional identification | 47 | $19.14 |
| 87254 | Virus culture, shell vial technique, each virus | 46 | $17.09 |
| 87255 | Virus culture with enzyme identification | 45 | $31.41 |
| 87260 | Adenovirus antigen test, immunofluorescence | 45 | $13.13 |
| 87265 | Whooping cough antigen test, immunofluorescence | 45 | $11.74 |
| 87267 | Enterovirus antigen test, immunofluorescence | 44 | $13.08 |
| 87269 | Giardia antigen test, immunofluorescence | 46 | $12.62 |
| 87270 | Chlamydia antigen test, immunofluorescence | 43 | $11.74 |
| 87271 | Cytomegalovirus antigen test, immunofluorescence | 45 | $12.84 |
| 87272 | Cryptosporidium antigen test, immunofluorescence | 45 | $11.74 |
| 87273 | Herpes simplex type 2 antigen test, immunofluorescence | 46 | $11.73 |
| 87274 | Herpes simplex type 1 antigen test, immunofluorescence | 45 | $11.74 |
| 87275 | Influenza B antigen test, immunofluorescence | 46 | $12.10 |
| 87276 | Influenza A antigen test, immunofluorescence | 45 | $14.46 |
| 87278 | Legionella antigen test, immunofluorescence | 45 | $14.04 |
| 87279 | Parainfluenza antigen test, immunofluorescence | 46 | $14.35 |
| 87280 | RSV antigen test, immunofluorescence | 45 | $13.08 |
| 87281 | Pneumocystis antigen test, immunofluorescence | 46 | $11.73 |
| 87283 | Measles antigen test, immunofluorescence | 46 | $48.64 |
| 87285 | Syphilis antigen test, immunofluorescence | 44 | $11.87 |
| 87290 | Varicella zoster antigen test, immunofluorescence | 45 | $12.87 |
| 87299 | Antigen test by immunofluorescence, other organism | 43 | $14.49 |
| 87301 | Adenovirus (enteric) antigen test | 45 | $11.74 |
| 87305 | Aspergillus antigen test | 45 | $11.73 |
| 87320 | Chlamydia antigen test, immunoassay | 44 | $13.50 |
| 87324 | C. difficile toxin antigen test | 45 | $11.68 |
| 87327 | Cryptococcus antigen test | 46 | $12.98 |
| 87328 | Cryptosporidium antigen test, immunoassay | 45 | $12.87 |
| 87329 | Giardia antigen test, immunoassay | 46 | $11.70 |
| 87332 | Cytomegalovirus antigen test | 45 | $11.71 |
| 87335 | E. coli O157 antigen test | 44 | $12.38 |
| 87336 | Entamoeba antigen test | 46 | $14.18 |
| 87337 | Entamoeba histolytica antigen test | 46 | $11.73 |
| 87338 | H. pylori stool antigen test | 44 | $13.34 |
| 87339 | H. pylori antigen test, other than stool | 44 | $14.23 |
| 87340 | Hepatitis B surface antigen | 46 | $10.23 |
| 87341 | Hepatitis B surface antigen confirmation | 46 | $10.33 |
| 87350 | Hepatitis B e antigen test | 46 | $11.12 |
| 87380 | Hepatitis D antigen test | 46 | $17.19 |
| 87385 | Histoplasma antigen test | 45 | $12.87 |
| 87389 | HIV antigen-antibody combination test | 46 | $23.00 |
| 87390 | HIV-1 antigen test | 46 | $21.31 |
| 87391 | HIV-2 antigen test | 45 | $19.71 |
| 87400 | Influenza A/B antigen test by immunoassay | 46 | $12.22 |
| 87420 | RSV antigen test, immunoassay | 45 | $12.87 |
| 87425 | Rotavirus antigen test | 45 | $11.68 |
| 87426 | Coronavirus (SARS-CoV-2) antigen test | 46 | $34.62 |
| 87427 | Shiga toxin test | 46 | $11.70 |
| 87428 | COVID-19 and influenza A/B combined antigen test | 45 | $62.89 |
| 87430 | Strep A antigen test, immunoassay | 46 | $14.81 |
| 87449 | Antigen test by immunoassay, other organism, each | 45 | $11.68 |
| 87467 | Hepatitis B surface antigen, quantitative | 40 | $20.26 |
| 87468 | Anaplasma DNA test, amplified | 39 | $30.91 |
| 87469 | Babesia DNA test, amplified | 40 | $30.94 |
| 87471 | Bartonella DNA test, amplified | 45 | $31.58 |
| 87472 | Bartonella DNA test, quantitative | 41 | $41.68 |
| 87475 | Lyme disease DNA test, direct probe | 44 | $19.85 |
| 87476 | Lyme disease DNA test, amplified | 45 | $33.51 |
| 87478 | Borrelia miyamotoi DNA test, amplified | 39 | $30.91 |
| 87480 | Candida DNA test, direct probe | 46 | $19.60 |
| 87481 | Candida DNA test, amplified | 46 | $31.58 |
| 87482 | Candida DNA test, quantitative | 43 | $49.16 |
| 87483 | Meningitis pathogen PCR panel, 12 to 25 targets | 38 | $375.10 |
| 87484 | Ehrlichia DNA test, amplified | 39 | $30.91 |
| 87485 | Chlamydia pneumoniae DNA test, direct probe | 44 | $19.85 |
| 87486 | Chlamydia pneumoniae by DNA/RNA amplification | 46 | $31.58 |
| 87487 | Chlamydia pneumoniae DNA test, quantitative | 41 | $40.91 |
| 87490 | Chlamydia DNA test, direct probe | 46 | $22.16 |
| 87491 | Chlamydia detection by DNA/RNA amplification | 46 | $31.58 |
| 87492 | Chlamydia DNA test, quantitative | 42 | $44.12 |
| 87493 | C. difficile toxin gene DNA test | 44 | $34.44 |
| 87495 | Cytomegalovirus DNA test, direct probe | 45 | $25.53 |
| 87496 | Cytomegalovirus DNA test, amplified | 45 | $33.51 |
| 87497 | Cytomegalovirus DNA test, quantitative | 46 | $41.30 |
| 87498 | Enterovirus RNA test, amplified | 45 | $34.14 |
| 87500 | Vancomycin resistance gene DNA test | 43 | $31.58 |
| 87501 | Influenza RNA test, amplified, each type | 45 | $46.18 |
| 87502 | Influenza DNA test, multiple types, first 2 | 46 | $86.22 |
| 87503 | Influenza RNA test, multiplex, each added type | 45 | $25.28 |
| 87505 | GI pathogen PCR panel, 3 to 5 targets | 41 | $122.51 |
| 87506 | GI pathogen PCR panel, 6 to 11 targets | 40 | $234.82 |
| 87507 | GI pathogen PCR panel, 12 to 25 targets | 41 | $375.10 |
| 87510 | Gardnerella by DNA probe | 46 | $19.53 |
| 87511 | Gardnerella DNA test, amplified | 44 | $31.58 |
| 87512 | Gardnerella DNA test, quantitative | 42 | $39.14 |
| 87516 | Hepatitis B DNA test, amplified | 45 | $33.51 |
| 87517 | Hepatitis B DNA test, quantitative | 46 | $40.54 |
| 87520 | Hepatitis C RNA test, direct probe | 43 | $26.54 |
| 87521 | Hepatitis C RNA test, amplified | 45 | $34.14 |
| 87522 | Hepatitis C RNA test, quantitative | 46 | $40.54 |
| 87525 | Hepatitis G RNA test, direct probe | 42 | $25.62 |
| 87526 | Hepatitis G RNA test, amplified | 43 | $35.33 |
| 87527 | Hepatitis G RNA test, quantitative | 41 | $39.87 |
| 87528 | Herpes simplex DNA test, direct probe | 44 | $19.60 |
| 87529 | Herpes simplex DNA test, amplified | 45 | $31.58 |
| 87530 | Herpes simplex DNA test, quantitative | 44 | $40.54 |
| 87531 | Herpes virus 6 DNA test, direct probe | 43 | $46.40 |
| 87532 | Herpes virus 6 DNA test, amplified | 44 | $31.58 |
| 87533 | Herpes virus 6 DNA test, quantitative | 44 | $37.58 |
| 87534 | HIV-1 DNA test, direct probe | 43 | $21.33 |
| 87535 | HIV-1 RNA test, amplified | 45 | $31.58 |
| 87536 | HIV-1 RNA test, quantitative (viral load) | 46 | $80.89 |
| 87537 | HIV-2 DNA test, direct probe | 43 | $21.33 |
| 87538 | HIV-2 RNA test, amplified | 44 | $32.55 |
| 87539 | HIV-2 RNA test, quantitative | 43 | $50.65 |
| 87540 | Legionella DNA test, direct probe | 43 | $19.65 |
| 87541 | Legionella DNA test, amplified | 44 | $31.58 |
| 87542 | Legionella DNA test, quantitative | 42 | $38.00 |
| 87550 | Mycobacteria DNA test, direct probe | 44 | $19.53 |
| 87551 | Mycobacteria DNA test, amplified | 45 | $42.91 |
| 87552 | Mycobacteria DNA test, quantitative | 42 | $40.54 |
| 87555 | Tuberculosis DNA test, direct probe | 45 | $24.19 |
| 87556 | Tuberculosis DNA test, amplified | 44 | $37.51 |
| 87557 | Tuberculosis DNA test, quantitative | 41 | $40.17 |
| 87560 | Mycobacterium avium DNA test, direct probe | 45 | $24.56 |
| 87561 | Mycobacterium avium DNA test, amplified | 44 | $32.55 |
| 87562 | Mycobacterium avium DNA test, quantitative | 41 | $40.91 |
| 87563 | Mycoplasma genitalium DNA test, amplified | 43 | $30.32 |
| 87580 | Mycoplasma pneumoniae DNA test, direct probe | 43 | $19.65 |
| 87581 | Mycoplasma pneumoniae DNA test, amplified | 44 | $31.58 |
| 87582 | Mycoplasma pneumoniae DNA test, quantitative | 41 | $242.10 |
| 87590 | Gonorrhea DNA test, direct probe | 44 | $24.19 |
| 87591 | Gonorrhea detection by DNA/RNA amplification | 46 | $31.58 |
| 87592 | Gonorrhea DNA test, quantitative | 42 | $38.56 |
| 87593 | Orthopoxvirus (mpox) DNA test, amplified | 38 | $45.64 |
| 87623 | HPV DNA test, low-risk types | 40 | $31.58 |
| 87624 | HPV DNA test, high-risk types | 46 | $31.58 |
| 87625 | HPV DNA test, types 16 and 18 | 45 | $36.50 |
| 87631 | Respiratory virus panel, 3 to 5 targets | 45 | $126.37 |
| 87632 | Respiratory virus panel, 6 to 11 targets | 44 | $194.28 |
| 87633 | Respiratory virus panel, 12 to 25 targets | 44 | $373.75 |
| 87634 | RSV RNA test, amplified | 44 | $63.18 |
| 87635 | COVID-19 (SARS-CoV-2) PCR test | 46 | $49.23 |
| 87636 | COVID-19 and influenza A/B PCR test | 45 | $133.72 |
| 87637 | COVID-19, influenza A/B and RSV PCR test | 45 | $133.72 |
| 87640 | Staph aureus DNA test, amplified | 45 | $34.14 |
| 87641 | MRSA DNA test, amplified | 46 | $33.83 |
| 87650 | Strep A DNA test, direct probe | 45 | $19.55 |
| 87651 | Strep A DNA test, amplified | 46 | $31.58 |
| 87652 | Strep A DNA test, quantitative | 41 | $39.49 |
| 87653 | Strep B DNA test, amplified | 45 | $34.14 |
| 87660 | Trichomonas DNA test, direct probe | 46 | $19.85 |
| 87661 | Trichomonas by DNA/RNA amplification | 46 | $31.58 |
| 87662 | Zika virus RNA test, amplified | 39 | $47.51 |
| 87797 | DNA test, direct probe, other organism, each | 45 | $25.90 |
| 87798 | DNA test, amplified, other organism, each | 46 | $32.55 |
| 87799 | DNA test, quantitative, other organism, each | 41 | $39.37 |
| 87800 | DNA test, multiple organisms, direct probe | 46 | $38.68 |
| 87801 | DNA test, multiple organisms, amplified | 46 | $60.69 |
| 87802 | Strep B rapid antigen test | 46 | $12.05 |
| 87803 | C. difficile toxin A rapid antigen test | 45 | $14.32 |
| 87804 | Influenza rapid test | 46 | $14.76 |
| 87806 | HIV rapid antigen-antibody test | 44 | $28.33 |
| 87807 | RSV rapid antigen test | 46 | $12.05 |
| 87808 | Trichomonas rapid antigen test | 45 | $13.76 |
| 87809 | Adenovirus rapid antigen test | 44 | $18.01 |
| 87810 | Chlamydia rapid antigen test | 45 | $28.23 |
| 87811 | COVID-19 rapid antigen test | 45 | $37.03 |
| 87850 | Gonorrhea rapid test | 45 | $20.33 |
| 87880 | Strep A rapid test | 47 | $14.58 |
| 87899 | Rapid antigen test, other organism | 44 | $14.25 |
| 87900 | HIV drug resistance prediction from genotype | 44 | $127.29 |
| 87901 | HIV-1 drug resistance genotype, RT and protease | 45 | $245.85 |
| 87902 | Hepatitis C genotype test | 45 | $231.71 |
| 87903 | HIV-1 drug resistance phenotype, up to 10 drugs | 45 | $478.89 |
| 87904 | HIV-1 drug resistance phenotype, each added drug | 45 | $25.55 |
| 87905 | Vaginal fluid sialidase enzyme test | 41 | $12.22 |
| 87906 | HIV-1 genotype, integrase or fusion region | 44 | $122.93 |
| 87910 | Cytomegalovirus genotype test | 42 | $229.51 |
| 87912 | Hepatitis B genotype test | 43 | $230.02 |
| 87913 | SARS-CoV-2 variant genotyping | 25 | $247.83 |
| 87999 | Unlisted microbiology test | 10 | $30.54 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.