Analysis for antibody to mycoplasma (bacteria)
Medicare pricing data for 655 providers across 33 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 to mycoplasma (bacteria) (HCPCS code 86738) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.94, but hospitals typically charge $62.95 — a 4.9x 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 $12.94, your out-of-pocket cost would be approximately $2.59. 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 4.9x more than what Medicare allows for this procedure. Medicare actually pays $12.94 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $13 | $105 | 6 | 701 | +0.3% |
| Georgia | $13 | $103 | 1 | 235 | +0.3% |
| Hawaii | $13 | $68 | 2 | 28 | +0.3% |
| Indiana | $13 | $79 | 2 | 22 | +0.3% |
| Kentucky | $13 | $56 | 3 | 31 | +0.3% |
| Maryland | $13 | $98 | 2 | 76 | +0.3% |
| Massachusetts | $13 | $87 | 5 | 393 | +0.3% |
| Minnesota | $13 | $125 | 3 | 32 | +0.3% |
| Nevada | $13 | $90 | 2 | 57 | +0.3% |
| New York | $13 | $64 | 14 | 654 | +0.3% |
| Oklahoma | $13 | $56 | 11 | 97 | +0.3% |
| Pennsylvania | $13 | $82 | 5 | 155 | +0.3% |
| South Dakota | $13 | $82 | 2 | 20 | +0.3% |
| Tennessee | $13 | $66 | 2 | 249 | +0.3% |
| Washington | $13 | $113 | 3 | 124 | +0.3% |
| Colorado | $13 | $123 | 2 | 71 | +0.3% |
| North Carolina | $13 | $113 | 6 | 2,794 | +0.2% |
| Texas | $13 | $21 | 17 | 7,648 | +0.2% |
| Utah | $13 | $29 | 3 | 42 | +0.2% |
| Puerto Rico | $13 | $16 | 354 | 3,376 | +0.2% |
| Ohio | $13 | $88 | 11 | 641 | +0.2% |
| Illinois | $13 | $128 | 6 | 481 | -0.1% |
| Iowa | $13 | $74 | 58 | 595 | -0.1% |
| Kansas | $13 | $83 | 19 | 248 | -0.1% |
| Alabama | $13 | $97 | 11 | 266 | -0.1% |
| Arizona | $13 | $113 | 5 | 1,357 | -0.2% |
| New Jersey | $13 | $93 | 7 | 3,247 | -0.3% |
| California | $13 | $77 | 19 | 2,633 | -0.6% |
| Mississippi | $13 | $81 | 36 | 274 | -2.3% |
| Virginia | $13 | $64 | 8 | 32 | -2.9% |
| Wisconsin | $12 | $61 | 5 | 20 | -4.7% |
| Michigan | $12 | $27 | 3 | 13 | -8.5% |
| South Carolina | $11 | $153 | 8 | 24 | -12.2% |
⚠️ 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