Screening test for strep antibody (strep throat)
Medicare pricing data for 54 providers across 6 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
Screening test for strep antibody (strep throat) (HCPCS code 86063) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.65, but hospitals typically charge $15.66 — a 2.8x 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 $5.65, your out-of-pocket cost would be approximately $1.13. 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 2.8x more than what Medicare allows for this procedure. Medicare actually pays $5.65 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $6 | $9 | 7 | 539 | +0.5% |
| Illinois | $6 | $16 | 6 | 1,520 | 0.0% |
| New Jersey | $6 | $15 | 4 | 381 | 0.0% |
| New York | $6 | $62 | 2 | 175 | 0.0% |
| Texas | $6 | $20 | 2 | 18 | 0.0% |
| California | $6 | $15 | 24 | 19,619 | 0.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber