81513

Measurement of rna of bacteria in vaginal fluid specimen

Medicare pricing data for 676 providers across 33 states

🤖AI Overview

Prices vary significantly by location — from $70 in Connecticut to $142 in Kansas. Where you get this procedure matters more than almost any other factor. 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

Measurement of rna of bacteria in vaginal fluid specimen (HCPCS code 81513) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $138.08, but hospitals typically charge $331.25 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.62

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $138.08, your out-of-pocket cost would be approximately $27.62. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$138.08
Average Hospital Charge
$331.25
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$331.25
Medicare Allowed$138.08
Medicare Payment$138.08

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $138.08 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kansas$142$3523348+2.8%
Delaware$140$357123+1.2%
Indiana$140$18915241+1.2%
Kentucky$140$4233602+1.2%
Maryland$140$34111,151+1.2%
New Hampshire$140$1561138+1.2%
New Jersey$140$34244,665+1.2%
Oklahoma$140$3283396+1.2%
South Carolina$140$298212+1.2%
Virginia$140$1823106+1.2%
Massachusetts$140$338233,644+1.2%
Pennsylvania$140$28863,084+1.1%
Illinois$139$339193,429+0.9%
Ohio$139$23741,191+0.9%
Florida$139$370157,840+0.9%
California$139$362435,068+0.8%
Arizona$139$378571,159+0.7%
Tennessee$139$2043501+0.6%
New Mexico$139$3202550+0.5%
Minnesota$139$24040102+0.5%
Louisiana$139$25822104+0.5%
Wisconsin$139$29921,334+0.4%
Texas$138$315742,094+0.3%
Oregon$138$20178933+0.3%
Puerto Rico$138$142291+0.2%
Washington$138$336168727+0.2%
Georgia$138$3413328+0.1%
New York$138$387461,736+0.1%
North Carolina$137$4253188-0.7%
Colorado$135$3283516-2.2%
Michigan$113$135335-18.0%
Nevada$111$1723206-19.6%
Connecticut$70$9313625-49.4%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber