Analysis for antibody bordetella (respiratory bacteria)
Medicare pricing data for 98 providers across 18 states
This procedure has a 10.2x markup — hospitals charge $131.69 but Medicare allows only $12.87. Uninsured patients may face bills 10.2 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 bordetella (respiratory bacteria) (HCPCS code 86615) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.87, but hospitals typically charge $131.69 — a 10.2x 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 $12.87, your out-of-pocket cost would be approximately $2.57. 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 10.2x more than what Medicare allows for this procedure. Medicare actually pays $12.87 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $13 | $149 | 5 | 181 | +0.6% |
| Georgia | $13 | $131 | 1 | 69 | +0.5% |
| Illinois | $13 | $130 | 2 | 31 | +0.5% |
| Kansas | $13 | $145 | 3 | 23 | +0.5% |
| Maryland | $13 | $113 | 3 | 20 | +0.5% |
| Massachusetts | $13 | $144 | 3 | 24 | +0.5% |
| New York | $13 | $91 | 5 | 83 | +0.5% |
| North Carolina | $13 | $157 | 6 | 2,202 | +0.5% |
| Oklahoma | $13 | $64 | 3 | 24 | +0.5% |
| Pennsylvania | $13 | $112 | 4 | 25 | +0.5% |
| Washington | $13 | $88 | 3 | 19 | +0.5% |
| Alabama | $13 | $162 | 4 | 244 | +0.5% |
| Colorado | $13 | $153 | 3 | 25 | +0.5% |
| Arizona | $13 | $120 | 2 | 2,269 | +0.3% |
| Texas | $13 | $122 | 7 | 285 | +0.2% |
| New Jersey | $13 | $115 | 7 | 659 | -0.4% |
| Ohio | $13 | $138 | 8 | 88 | -1.7% |
| California | $12 | $104 | 9 | 401 | -4.7% |
⚠️ 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