86060

Measurement for strep antibody (strep throat)

Medicare pricing data for 283 providers across 34 states

🤖AI Overview

This procedure has a 6.5x markup — hospitals charge $46.26 but Medicare allows only $7.14. Uninsured patients may face bills 6.5 times higher than what insurance negotiates. 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 for strep antibody (strep throat) (HCPCS code 86060) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.14, but hospitals typically charge $46.26 — a 6.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.14, your out-of-pocket cost would be approximately $1.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.14
Average Hospital Charge
$46.26
Markup Ratio
6.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$46.26
Medicare Allowed$7.14
Medicare Payment$7.14

Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $7.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$7$35121,863+0.1%
Georgia$7$582438+0.1%
Hawaii$7$252142+0.1%
Idaho$7$45214+0.1%
Illinois$7$48242,410+0.1%
Indiana$7$29212+0.1%
Iowa$7$38416+0.1%
Kansas$7$585546+0.1%
Louisiana$7$61173+0.1%
Maryland$7$64676+0.1%
Massachusetts$7$602148+0.1%
Michigan$7$49411+0.1%
Minnesota$7$80329+0.1%
Mississippi$7$99532+0.1%
Nevada$7$63231+0.1%
New Jersey$7$40215,946+0.1%
New Mexico$7$39173+0.1%
New York$7$50232,709+0.1%
Pennsylvania$7$277320+0.1%
South Carolina$7$15429+0.1%
Virginia$7$225103+0.1%
Washington$7$626148+0.1%
Arizona$7$585556+0.1%
Colorado$7$612146+0.1%
Texas$7$85172,1940.0%
California$7$35336,3040.0%
North Carolina$7$5281,688-0.1%
Ohio$7$48111,139-0.1%
Alabama$7$545792-0.3%
Tennessee$7$48498-0.7%
Oklahoma$7$554224-1.0%
Oregon$7$373206-1.0%
Arkansas$7$181591-1.7%
Wisconsin$6$65833-10.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber