CPT 87426: SARS–CoV–2 Antigen Immunoassay, Blood
Commercial payers pay $39 on average nationally for this procedure.
CPT code 87426 describes a laboratory immunoassay performed to qualitatively or semiquantitatively detect antigens of severe acute respiratory syndrome coronavirus (such as SARS–CoV–2) in a patient blood specimen, representing a diagnostic infectious agent antigen test typically performed by clinical laboratory personnel; service type: laboratory diagnostic test; typical site of service: clinical laboratory or hospital laboratory.
For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.
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National Reimbursement Benchmarks
National commercial rates for CPT 87426 center on BUCA’s mean of $38.70 as the average commercial benchmark, with individual payer medians and means showing meaningful variation. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $13.00, Cigna’s spread is $24.40, Aetna’s spread is $11.10, and UnitedHealth Group’s spread is $22.60, indicating that Blue Cross Blue Shield and Aetna have the tightest middle-range dispersions while Cigna and UnitedHealth Group exhibit wider volatility in the middle 50% of rates.
Looking at extremes and central tendency, Aetna and UnitedHealth Group show the largest upper-end maximums at $114.80 and $140.00 respectively, while Cigna and Aetna include the lowest observed minimums at $5.20 and $9.10. BUCA’s mean of $38.70 sits near the midpoint of payer means, underscoring that average commercial reimbursement falls in the high $30s despite notable payer-specific spread differences.