Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected
Medicare pricing data for 1,419 providers across 33 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected (HCPCS code 0240U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $139.71, but hospitals typically charge $287.42 — a 2.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $139.71, your out-of-pocket cost would be approximately $27.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $139.71 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Illinois | $140 | $301 | 22 | 149,774 | +0.1% |
| Michigan | $140 | $284 | 49 | 299 | +0.1% |
| New Hampshire | $140 | $169 | 23 | 49 | +0.1% |
| New Jersey | $140 | $217 | 6 | 212 | +0.1% |
| New Mexico | $140 | $200 | 1 | 14 | +0.1% |
| New York | $140 | $429 | 13 | 33 | +0.1% |
| South Carolina | $140 | $169 | 9 | 45 | +0.1% |
| Alaska | $140 | $680 | 6 | 19 | +0.1% |
| Arizona | $140 | $259 | 4 | 226 | +0.1% |
| Florida | $140 | $204 | 97 | 26,446 | +0.0% |
| California | $140 | $302 | 27 | 14,561 | +0.0% |
| Kansas | $140 | $264 | 94 | 851 | -0.0% |
| Minnesota | $139 | $299 | 209 | 805 | -0.2% |
| North Dakota | $139 | $389 | 52 | 427 | -0.2% |
| South Dakota | $139 | $218 | 55 | 648 | -0.2% |
| Virginia | $139 | $252 | 17 | 309 | -0.2% |
| Colorado | $139 | $188 | 10 | 75 | -0.3% |
| Missouri | $139 | $318 | 68 | 167 | -0.4% |
| Arkansas | $139 | $270 | 39 | 589 | -0.5% |
| Texas | $139 | $298 | 12 | 101 | -0.6% |
| North Carolina | $139 | $204 | 53 | 490 | -0.8% |
| Iowa | $139 | $314 | 51 | 758 | -0.9% |
| Ohio | $138 | $234 | 172 | 541 | -0.9% |
| Washington | $138 | $179 | 42 | 210 | -0.9% |
| Pennsylvania | $138 | $307 | 71 | 306 | -1.3% |
| Tennessee | $138 | $242 | 23 | 400 | -1.3% |
| Oklahoma | $138 | $440 | 48 | 674 | -1.4% |
| Maryland | $138 | $297 | 35 | 119 | -1.6% |
| Nebraska | $137 | $156 | 11 | 60 | -1.6% |
| Wisconsin | $137 | $311 | 36 | 2,080 | -1.8% |
| Georgia | $136 | $265 | 19 | 38 | -2.6% |
| Alabama | $127 | $159 | 5 | 51 | -9.3% |
| Oregon | $126 | $223 | 21 | 31 | -10.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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