Procalcitonin test is a laboratory test. Prices are from 2320 US hospitals across 52 states, from their machine-readable files.
Price comparison (median)
Typical cash price here is $148 — about 5.4× the Medicare rate ($27). High vs Medicare. A fair cash price is usually within ~2× Medicare ($54).
💡 Asking for the cash price instead of the $259 list price could save about $111 (43%).
Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.
Lowest cash prices
| Hospital | Location | Cash | Insurer | CMS rating | ER wait | Readmit |
|---|---|---|---|---|---|---|
| Ochsner St Mary | Morgan City, LA | $23 | $28 | ★ 2/5 | 81 min | 15.4% |
| Ochsner LSU Health Shreveport-St Mary Medical Cent | Shreveport, LA | $23 | $28 | ★ 2/5 | — | — |
| Banner Casa Grande Medical Center | Casa Grande, AZ | $23 | $37 | ★ 2/5 | 175 min | 16.6% |
| Heritage Valley Beaver | Beaver, PA | $24 | $27 | ★ 3/5 | 185 min | 14.5% |
| Heritage Valley Sewickley | Sewickley, PA | $24 | $27 | ★ 4/5 | 132 min | 15.1% |
| Jennie Stuart Medical Center | Hopkinsville, KY | $24 | $54 | ★ 1/5 | 156 min | 15.5% |
| UNC Lenoir Health Care | Kinston, NC | $25 | $36 | ★ 4/5 | 200 min | 15.8% |
| Marlette Regional Hospital | Marlette, MI | $26 | $23 | — | 107 min | 15.0% |
| Aurelia Osborn Fox Memorial Hospital | Oneonta, NY | $26 | $27 | ★ 3/5 | 123 min | 15.2% |
| Bassett Healthcare | Cooperstown, NY | $26 | $29 | ★ 2/5 | 199 min | 15.6% |
| O'connor Hospital | Delhi, NY | $26 | $42 | — | 88 min | 14.7% |
| Little Falls Hospital | Little Falls, NY | $26 | $35 | ★ 2/5 | 110 min | 15.7% |
| Cobleskill Regional Hospital | Cobleskill, NY | $26 | $41 | ★ 4/5 | 109 min | 14.6% |
| Methodist Jennie Edmundson | Council Bluffs, IA | $26 | $43 | ★ 3/5 | 149 min | 15.8% |
| Banner Baywood Medical Center | Mesa, AZ | $26 | $40 | ★ 2/5 | 266 min | 13.9% |
| University of Kansas Hospital | Kansas City, KS | $26 | $92 | ★ 5/5 | 307 min | 14.1% |
| University of Ks Hlth System Great Bend Campus | Great Bend, KS | $26 | $79 | ★ 4/5 | 107 min | 14.5% |
| Acmh Hospital | Kittanning, PA | $26 | $31 | ★ 3/5 | 198 min | 15.0% |
| Nocona General Hospital | Nocona, TX | $27 | $189 | ★ 1/5 | 104 min | 15.9% |
| Riverview Regional Medical Center | Gadsden, AL | $27 | $27 | ★ 3/5 | 160 min | 15.7% |
| Paradise Valley Hospital | National City, CA | $27 | $27 | ★ 3/5 | 202 min | 16.0% |
| Saint Francis Medical Center | Lynwood, CA | $27 | $27 | ★ 3/5 | 250 min | 14.9% |
| Encino Hospital Medical Center | Encino, CA | $27 | $27 | ★ 3/5 | 135 min | 15.6% |
| Garden Grove Hospital & Medical Center | Garden Grove, CA | $27 | $27 | ★ 2/5 | 138 min | 16.6% |
| West Anaheim Medical Center | Anaheim, CA | $27 | $27 | ★ 2/5 | 196 min | 16.6% |
CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated August 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.
What insurers pay for Procalcitonin test
Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $148; Medicare pays $27.
| Insurer | Hospitals | Negotiated median |
|---|---|---|
| Amerigroup | 174 |
$17 – $134 |
| UnitedHealthcare | 1523 |
$22 – $203 |
| Tricare / VA | 433 |
$26 – $212 |
| Medicare | 555 |
$27 – $104 |
| Medicaid | 319 |
$18 – $166 |
| Devoted Health | 247 |
$27 – $31 |
| Independent Health | 51 |
$24 – $43 |
| Highmark | 120 |
$18 – $125 |
| AmeriHealth | 246 |
$22 – $103 |
| MVP Health Care | 73 |
$24 – $128 |
| Molina Healthcare | 551 |
$17 – $78 |
| Bright Health | 65 |
$27 – $54 |
| Centene / Ambetter | 802 |
$25 – $201 |
| UPMC Health Plan | 99 |
$26 – $162 |
| Univera | 15 |
$23 – $40 |
| EmblemHealth | 59 |
$27 – $162 |
| Geisinger | 68 |
$26 – $132 |
| Humana | 1053 |
$27 – $298 |
| Kaiser Permanente | 229 |
$22 – $354 |
| Anthem | 587 |
$18 – $182 |
| Oscar Health | 214 |
$27 – $92 |
| AvMed | 60 |
$16 – $137 |
| SelectHealth | 44 |
$27 – $294 |
| Blue Cross Blue Shield | 1292 |
$27 – $279 |
| Health Net | 309 |
$27 – $300 |
| UCare | 65 |
$27 – $207 |
| Aetna | 1391 |
$26 – $290 |
| Priority Health | 53 |
$19 – $204 |
| Harvard Pilgrim | 51 |
$27 – $167 |
| Cigna | 1172 |
$26 – $295 |
| Workers' Comp / No-Fault | 143 |
$27 – $438 |
| Medica | 242 |
$27 – $285 |
| Coventry | 152 |
$27 – $299 |
| HealthPartners | 262 |
$28 – $270 |
| Sanford Health Plan | 68 |
$47 – $261 |
| Security Health Plan | 53 |
$27 – $224 |
| Healthcare Highways | 49 |
$46 – $378 |
| MultiPlan / PHCS network | 860 |
$59 – $465 |
Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.
Where it’s cheapest
| State | Median cash |
|---|---|
| New Jersey | $31 |
| Arizona | $75 |
| Arkansas | $75 |
| Alabama | $80 |
| Tennessee | $81 |
| Nevada | $84 |
Prices by city
Prices by state
Does Medicare cover Procalcitonin test?
Yes — Medicare generally covers Procalcitonin test. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $27. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $5 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.
General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.
About these prices
Based on prices published by 2320 US hospitals across 52 states, the typical (median) cash price is $148, versus a chargemaster (list) price around $259, a median insurer-negotiated rate of $49, a Medicare rate of about $27. Most cash prices fall between $42 and $419 — a wide spread, which is exactly why comparing hospitals pays off.
How to save
- Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
- Compare several nearby hospitals; prices for the same service can differ severalfold.
- Request a written estimate and the billing code (CPT/DRG) before scheduling.
- Use the Medicare benchmark above to judge whether a quote is reasonable.
- If you are uninsured, ask about financial assistance or prompt-pay discounts.
Frequently asked questions
How much does Procalcitonin test cost without insurance?
Does Medicare cover Procalcitonin test?
What does Medicare pay for Procalcitonin test?
Why do Procalcitonin test prices vary between hospitals?
Is the cash price lower than using insurance?
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