Analysis for antibody to histoplasma (fungus)
Medicare pricing data for 125 providers across 29 states
This procedure has a 6.5x markup — hospitals charge $87.26 but Medicare allows only $13.41. Uninsured patients may face bills 6.5 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 to histoplasma (fungus) (HCPCS code 86698) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.41, but hospitals typically charge $87.26 — a 6.5x 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 $13.41, your out-of-pocket cost would be approximately $2.68. 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 6.5x more than what Medicare allows for this procedure. Medicare actually pays $13.41 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $14 | $109 | 3 | 277 | +0.7% |
| Hawaii | $14 | $43 | 2 | 20 | +0.7% |
| Illinois | $14 | $85 | 4 | 314 | +0.7% |
| Indiana | $14 | $39 | 2 | 60 | +0.7% |
| Iowa | $14 | $23 | 4 | 112 | +0.7% |
| Kentucky | $14 | $45 | 2 | 71 | +0.7% |
| Maryland | $14 | $78 | 3 | 47 | +0.7% |
| Massachusetts | $14 | $82 | 3 | 39 | +0.7% |
| Nevada | $14 | $81 | 2 | 604 | +0.7% |
| New Mexico | $14 | $24 | 1 | 41 | +0.7% |
| New York | $14 | $63 | 3 | 30 | +0.7% |
| North Carolina | $14 | $122 | 2 | 571 | +0.7% |
| Oklahoma | $14 | $76 | 3 | 194 | +0.7% |
| Pennsylvania | $14 | $91 | 4 | 37 | +0.7% |
| South Dakota | $14 | $67 | 2 | 83 | +0.7% |
| Tennessee | $14 | $50 | 2 | 34 | +0.7% |
| Texas | $14 | $90 | 10 | 735 | +0.7% |
| Utah | $14 | $28 | 3 | 138 | +0.7% |
| Washington | $14 | $119 | 3 | 45 | +0.7% |
| Wisconsin | $14 | $107 | 4 | 93 | +0.7% |
| Alabama | $14 | $113 | 2 | 27 | +0.7% |
| Arizona | $14 | $104 | 3 | 325 | +0.7% |
| Kansas | $13 | $79 | 5 | 681 | +0.4% |
| Minnesota | $13 | $99 | 5 | 1,296 | +0.4% |
| Florida | $13 | $118 | 5 | 233 | +0.1% |
| New Jersey | $13 | $97 | 4 | 157 | -0.1% |
| Ohio | $13 | $66 | 9 | 143 | -2.0% |
| California | $13 | $77 | 13 | 1,292 | -2.2% |
| Virginia | $11 | $27 | 5 | 42 | -19.5% |
⚠️ 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