86317

Detection of infectious agent antibody, quantitative

Medicare pricing data for 686 providers across 40 states

🤖AI Overview

This procedure has a 7.8x markup — hospitals charge $113.18 but Medicare allows only $14.58. Uninsured patients may face bills 7.8 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

Detection of infectious agent antibody, quantitative (HCPCS code 86317) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.58, but hospitals typically charge $113.18 — a 7.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.58, your out-of-pocket cost would be approximately $2.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.58
Average Hospital Charge
$113.18
Markup Ratio
7.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$113.18
Medicare Allowed$14.58
Medicare Payment$14.58

Hospitals charge 7.8x more than what Medicare allows for this procedure. Medicare actually pays $14.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$15$6841,722+0.8%
Georgia$15$21372,467+0.8%
Idaho$15$30167+0.8%
Louisiana$15$454161+0.8%
Maine$15$92373+0.8%
Massachusetts$15$175103,162+0.8%
Mississippi$15$56711125+0.8%
Nevada$15$2252334+0.8%
New York$15$1191383,704+0.8%
Pennsylvania$15$193101,045+0.8%
South Carolina$15$82595+0.8%
South Dakota$15$46237+0.8%
West Virginia$15$54236+0.8%
Wisconsin$15$913243+0.8%
Puerto Rico$15$171525+0.8%
Alaska$15$116725+0.8%
Colorado$15$1645317+0.8%
Florida$15$1721514,683+0.7%
Illinois$15$194992,201+0.7%
Maryland$15$143421,735+0.7%
Kansas$15$26442,238+0.6%
Texas$15$722427,103+0.6%
Oklahoma$15$1616735+0.4%
Ohio$15$82362,568+0.3%
Washington$15$124492,159+0.3%
New Jersey$15$1381615,610+0.2%
Arizona$15$9255,628+0.1%
California$15$972728,751+0.1%
North Carolina$15$88126,8980.0%
Indiana$15$575449-0.4%
Hawaii$14$1402176-0.9%
Alabama$14$7941,158-1.5%
Tennessee$14$4445965-1.6%
Michigan$14$4511279-1.7%
Kentucky$14$44222-3.8%
Missouri$13$21182,032-10.7%
Utah$13$265546-12.6%
Virginia$13$425875-13.0%
Oregon$12$716260-18.0%
Iowa$8$20262-43.8%

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

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