Analysis for antibody to candida (yeast)
Medicare pricing data for 94 providers across 26 states
This procedure has a 6.8x markup — hospitals charge $79.91 but Medicare allows only $11.70. Uninsured patients may face bills 6.8 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
Analysis for antibody to candida (yeast) (HCPCS code 86628) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.70, but hospitals typically charge $79.91 — a 6.8x 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 $11.70, your out-of-pocket cost would be approximately $2.34. 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 6.8x more than what Medicare allows for this procedure. Medicare actually pays $11.70 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $12 | $68 | 5 | 1,025 | +0.6% |
| Georgia | $12 | $73 | 1 | 553 | +0.6% |
| Hawaii | $12 | $49 | 2 | 66 | +0.6% |
| Illinois | $12 | $78 | 1 | 1,133 | +0.6% |
| Indiana | $12 | $43 | 1 | 22 | +0.6% |
| Kansas | $12 | $71 | 2 | 199 | +0.6% |
| Louisiana | $12 | $27 | 1 | 72 | +0.6% |
| Maryland | $12 | $69 | 1 | 651 | +0.6% |
| Massachusetts | $12 | $65 | 2 | 888 | +0.6% |
| New York | $12 | $74 | 4 | 178 | +0.6% |
| Ohio | $12 | $99 | 6 | 191 | +0.6% |
| Oklahoma | $12 | $69 | 3 | 178 | +0.6% |
| Oregon | $12 | $25 | 2 | 84 | +0.6% |
| Pennsylvania | $12 | $61 | 4 | 186 | +0.6% |
| Texas | $12 | $75 | 10 | 894 | +0.6% |
| Utah | $12 | $48 | 2 | 37 | +0.6% |
| Virginia | $12 | $55 | 2 | 39 | +0.6% |
| Washington | $12 | $67 | 3 | 323 | +0.6% |
| Alabama | $12 | $68 | 3 | 49 | +0.6% |
| Arizona | $12 | $57 | 2 | 210 | +0.6% |
| Colorado | $12 | $63 | 2 | 61 | +0.6% |
| New Jersey | $12 | $117 | 7 | 2,598 | -0.6% |
| California | $12 | $62 | 12 | 1,112 | -1.0% |
| Nevada | $12 | $82 | 1 | 258 | -1.6% |
| North Carolina | $11 | $62 | 3 | 275 | -2.3% |
| Wisconsin | $10 | $99 | 2 | 14 | -13.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber