Procalcitonin test Cost by Hospital

Procalcitonin test is a laboratory test. Prices are from 2320 US hospitals across 52 states, from their machine-readable files.

$148median cash price · 2320 hospitals, 52 statestypically $42–$419 depending on the hospital
≈ 5.4× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$259
Cash / self-pay
$148
Insurer-negotiated
$49
Medicare pays
$27
$42$419
Median cash $148  ·  Medicare $27  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

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%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
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.

InsurerHospitalsNegotiated median
Amerigroup 174
$27
$17 – $134
UnitedHealthcare 1523
$27
$22 – $203
Tricare / VA 433
$27
$26 – $212
Medicare 555
$27
$27 – $104
Medicaid 319
$27
$18 – $166
Devoted Health 247
$27
$27 – $31
Independent Health 51
$28
$24 – $43
Highmark 120
$28
$18 – $125
AmeriHealth 246
$29
$22 – $103
MVP Health Care 73
$29
$24 – $128
Molina Healthcare 551
$30
$17 – $78
Bright Health 65
$30
$27 – $54
Centene / Ambetter 802
$31
$25 – $201
UPMC Health Plan 99
$31
$26 – $162
Univera 15
$33
$23 – $40
EmblemHealth 59
$35
$27 – $162
Geisinger 68
$36
$26 – $132
Humana 1053
$36
$27 – $298
Kaiser Permanente 229
$37
$22 – $354
Anthem 587
$39
$18 – $182
Oscar Health 214
$45
$27 – $92
AvMed 60
$49
$16 – $137
SelectHealth 44
$53
$27 – $294
Blue Cross Blue Shield 1292
$53
$27 – $279
Health Net 309
$61
$27 – $300
UCare 65
$62
$27 – $207
Aetna 1391
$65
$26 – $290
Priority Health 53
$67
$19 – $204
Harvard Pilgrim 51
$68
$27 – $167
Cigna 1172
$77
$26 – $295
Workers' Comp / No-Fault 143
$82
$27 – $438
Medica 242
$95
$27 – $285
Coventry 152
$103
$27 – $299
HealthPartners 262
$112
$28 – $270
Sanford Health Plan 68
$132
$47 – $261
Security Health Plan 53
$141
$27 – $224
Healthcare Highways 49
$186
$46 – $378
MultiPlan / PHCS network 860
$194
$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

StateMedian 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?
The median cash (self-pay) price across 2320 US hospitals is $148. Most hospitals fall between $42 and $419. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Procalcitonin test?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $27). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Procalcitonin test?
Medicare pays about $27. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Procalcitonin test prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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