86580

Skin test for tuberculosis

Medicare pricing data for 17,931 providers across 50 states

🤖AI Overview

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

Skin test for tuberculosis (HCPCS code 86580) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.82, but hospitals typically charge $27.76 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.82, your out-of-pocket cost would be approximately $1.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$9.82
Average Hospital Charge
$27.76
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$27.76
Medicare Allowed$9.82
Medicare Payment$6.42

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $6.42 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$12$2964104+20.1%
New Jersey$11$311,0031,539+16.9%
New York$11$291,2862,392+16.9%
California$11$328341,766+16.9%
Maryland$11$29563923+14.7%
Hawaii$11$253550+14.0%
Massachusetts$11$34225306+12.7%
Connecticut$11$25215287+11.9%
Alaska$11$533660+10.4%
Rhode Island$10$281314+6.4%
Illinois$10$30279395+4.8%
Washington$10$323545+4.6%
Colorado$10$23128187+4.4%
New Hampshire$10$241824+3.6%
Delaware$10$22115173+3.0%
Minnesota$10$295159+2.0%
Virginia$10$271,0411,878+1.9%
Wyoming$10$211631+1.8%
Oregon$10$301522+1.5%
South Dakota$10$24912+1.1%
Nevada$10$292733+1.0%
Pennsylvania$10$271,5662,530+0.8%
Vermont$10$211215+0.4%
Michigan$10$22550967+0.1%
Florida$10$21229662-1.4%
Montana$10$181032-1.4%
Arizona$10$24145205-2.1%
Texas$10$29579904-2.3%
Maine$10$241621-3.1%
Utah$9$173142-3.9%
Georgia$9$301,3802,878-4.7%
Wisconsin$9$50151196-5.8%
North Carolina$9$301,6162,958-5.9%
Missouri$9$27474945-6.1%
Ohio$9$29438607-6.4%
New Mexico$9$265468-7.2%
South Carolina$9$261,2213,091-7.5%
Idaho$9$232024-7.7%
Indiana$9$256291,015-8.4%
Louisiana$9$25122164-8.5%
Kansas$9$27325512-8.7%
Iowa$9$27164237-8.9%
Nebraska$9$3680172-9.1%
Tennessee$9$246471,090-9.9%
Oklahoma$9$236064-10.1%
Kentucky$9$30443867-10.7%
Alabama$9$18471830-11.9%
Mississippi$8$25313663-13.5%
Arkansas$8$2090128-13.8%
West Virginia$8$1971143-18.2%

⚠️ 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