How can I find out the cost of a medical procedure?

To find out the cost of a specific medical procedure, you'll need to know the CPT (Current Procedural Terminology) code and your specific location. For accurate and specific pricing information, you can use tools like Payerprice's fee schedule lookup, which allows you to search with a CPT code and location to get relevant fee schedule data.

What is a CPT code and why is it important for understanding healthcare costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. It's crucial for understanding healthcare costs because it standardizes the identification of services, allowing you to look up the specific price for a given procedure. Knowing the CPT code enables you to use tools like Payerprice to find fee schedules and understand what you might pay.

Why do healthcare costs vary so much?

Healthcare costs can vary significantly due to several factors, including the type of service, the provider (e.g., hospital vs. independent clinic), geographic location, insurance company negotiations, and whether the service is in-network or out-of-network. Different payers (insurance companies) negotiate different rates with providers, leading to a wide range of prices for the same service.

Where can I find a fee schedule for medical services?

Fee schedules for medical services are often specific to insurance plans, providers, and locations. While some general information might be publicly available, for precise and current fee schedule data tailored to your situation (e.g., CPT code and specific location), you should use a dedicated lookup tool. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your location to find relevant pricing information.

What's the difference between a negotiated rate and a billed charge?

The 'billed charge' is the initial amount that a healthcare provider charges for a service, often its list price. The 'negotiated rate' (or allowed amount) is the amount that your health insurance company has agreed to pay the provider for that service. This rate is typically lower than the billed charge. Your out-of-pocket costs (copay, deductible, coinsurance) are usually based on the negotiated rate, not the billed charge.

CPT 87591 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Neisseria Gon, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Neisseria Gon

Key Fact	Detail
Service Type	Pathology and Laboratory Procedures Microbiology Procedures
Common Place of Service	81 - Independent Laboratory 11 - Office
Common Modifiers	None 59 - Distinct Procedural Service 90 - Reference Laboratory
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 87591
Medicaid Fee Schedule	View Medicaid rates for 87591

National average reimbursement for CPT 87591 by major payers:

$32.22

$25.02

$41.61

$50.97

Compare published rates across providers.

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CPT 87591

5 of 25 sample ratesHigher to lower in this preview

Syed Zaman
Slocum Dickson Medical Group PLLC
NYAnatomic Pathology & Clinical Pathology PhysicianNPI 1295729143Tax ID 20-0362623
$40.34Published rate
Slocum Dickson Medical Group PLLC
NYClinic/CenterNPI 1285625996Tax ID 20-0362623
$29.14Published rate
Carly Zegarelli
Slocum Dickson Medical Group PLLC
NYPhysical TherapistNPI 1093316879Tax ID 20-0362623
$29.14Published rate
Scott Peplinski
Slocum Dickson Medical Group PLLC
NYDiagnostic Radiology PhysicianNPI 1861456444Tax ID 20-0362623
$14.73Published rate
Gabriella Pladocostante
Slocum Dickson Medical Group PLLC
NYMedical Physician AssistantNPI 1982313656Tax ID 20-0362623
$14.73Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 87591 vs. Other Microbiology Procedures Codes

The CPT 87591 code is part of the Pathology and Laboratory Procedures services used for Microbiology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 87591 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
87534-CPT	Low	Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Hiv-1 Direct Probe Technique Infectious Ag Ent Detection By Nucleic Acid (Dna Or Rna)
87590-CPT	Low	Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Neisseria Gonorrhoeae Direct Probe Techniqu E Infectious Agent Detection By Nucleic Acid (Dnaor Rna)
87591-CPT	Low	Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Neisseria Gon, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Neisseria Gon
87592-CPT	Low	Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Neisseria Gonorrhoeae Quantification Infec Tious Agent Detection By Nucleic Acid (Dna Or Rna)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87591. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 87591 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 87591 Fee Schedule

Syed Zaman

Slocum Dickson Medical Group PLLC

Carly Zegarelli

Scott Peplinski

Gabriella Pladocostante