Analysis for antibody bacteria
Medicare pricing data for 110 providers across 26 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
Analysis for antibody bacteria (HCPCS code 86609) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.57, but hospitals typically charge $40.99 — a 3.3x 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 $12.57, your out-of-pocket cost would be approximately $2.51. 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 3.3x more than what Medicare allows for this procedure. Medicare actually pays $12.57 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $13 | $50 | 5 | 1,726 | +0.4% |
| Georgia | $13 | $54 | 1 | 1,093 | +0.4% |
| Hawaii | $13 | $18 | 1 | 56 | +0.4% |
| Illinois | $13 | $50 | 4 | 432 | +0.4% |
| Indiana | $13 | $16 | 1 | 60 | +0.4% |
| Kansas | $13 | $58 | 4 | 861 | +0.4% |
| Maryland | $13 | $47 | 4 | 454 | +0.4% |
| Massachusetts | $13 | $50 | 3 | 219 | +0.4% |
| Nevada | $13 | $55 | 1 | 643 | +0.4% |
| New York | $13 | $35 | 4 | 773 | +0.4% |
| Ohio | $13 | $79 | 5 | 142 | +0.4% |
| Oklahoma | $13 | $43 | 2 | 77 | +0.4% |
| Pennsylvania | $13 | $55 | 5 | 151 | +0.4% |
| Tennessee | $13 | $97 | 1 | 31 | +0.4% |
| Texas | $13 | $50 | 10 | 1,955 | +0.4% |
| Washington | $13 | $69 | 5 | 336 | +0.4% |
| Wisconsin | $13 | $91 | 1 | 200 | +0.4% |
| Alabama | $13 | $96 | 2 | 90 | +0.4% |
| Colorado | $13 | $84 | 4 | 47 | +0.4% |
| California | $13 | $34 | 13 | 31,912 | +0.3% |
| North Carolina | $13 | $96 | 4 | 1,680 | +0.2% |
| Arizona | $13 | $43 | 4 | 1,082 | +0.1% |
| New Jersey | $13 | $56 | 5 | 2,215 | -0.6% |
| South Dakota | $12 | $49 | 1 | 92 | -3.3% |
| South Carolina | $11 | $47 | 3 | 51 | -9.5% |
| Virginia | $7 | $14 | 4 | 290 | -42.3% |
⚠️ 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