Bacterial blood culture
Medicare pricing data for 870 providers across 44 states
This procedure has a 8.4x markup — hospitals charge $84.60 but Medicare allows only $10.07. Uninsured patients may face bills 8.4 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
Bacterial blood culture (HCPCS code 87040) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.07, but hospitals typically charge $84.60 — a 8.4x 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 $10.07, your out-of-pocket cost would be approximately $2.01. 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 8.4x more than what Medicare allows for this procedure. Medicare actually pays $10.07 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Hawaii | $10 | $39 | 2 | 414 | +0.4% |
| Illinois | $10 | $77 | 17 | 1,538 | +0.4% |
| Indiana | $10 | $73 | 5 | 131 | +0.4% |
| Maine | $10 | $56 | 3 | 150 | +0.4% |
| Massachusetts | $10 | $84 | 124 | 1,862 | +0.4% |
| Michigan | $10 | $30 | 8 | 96 | +0.4% |
| Missouri | $10 | $116 | 6 | 280 | +0.4% |
| Montana | $10 | $64 | 1 | 13 | +0.4% |
| Nevada | $10 | $51 | 6 | 1,005 | +0.4% |
| New Mexico | $10 | $56 | 3 | 110 | +0.4% |
| New York | $10 | $109 | 44 | 2,870 | +0.4% |
| Rhode Island | $10 | $40 | 2 | 98 | +0.4% |
| South Carolina | $10 | $41 | 6 | 83 | +0.4% |
| South Dakota | $10 | $74 | 5 | 80 | +0.4% |
| Tennessee | $10 | $72 | 8 | 546 | +0.4% |
| Utah | $10 | $45 | 4 | 144 | +0.4% |
| Puerto Rico | $10 | $21 | 8 | 17 | +0.4% |
| Arkansas | $10 | $34 | 10 | 13 | +0.4% |
| Connecticut | $10 | $69 | 2 | 24 | +0.4% |
| Virginia | $10 | $50 | 7 | 811 | +0.3% |
| California | $10 | $78 | 68 | 11,452 | +0.3% |
| Kansas | $10 | $111 | 7 | 1,226 | +0.2% |
| Minnesota | $10 | $78 | 155 | 1,382 | +0.2% |
| Arizona | $10 | $80 | 22 | 1,681 | +0.2% |
| Pennsylvania | $10 | $93 | 10 | 853 | +0.1% |
| Texas | $10 | $93 | 45 | 4,254 | +0.1% |
| Florida | $10 | $107 | 29 | 4,791 | 0.0% |
| Georgia | $10 | $110 | 6 | 783 | 0.0% |
| New Jersey | $10 | $91 | 14 | 7,928 | 0.0% |
| Ohio | $10 | $67 | 13 | 1,442 | 0.0% |
| Oregon | $10 | $52 | 7 | 243 | 0.0% |
| Alabama | $10 | $73 | 18 | 1,285 | 0.0% |
| Maryland | $10 | $88 | 10 | 979 | -0.1% |
| North Carolina | $10 | $80 | 12 | 2,692 | -0.1% |
| Colorado | $10 | $93 | 7 | 553 | -0.1% |
| Iowa | $10 | $42 | 45 | 472 | -0.3% |
| Oklahoma | $10 | $92 | 6 | 622 | -0.3% |
| Nebraska | $10 | $35 | 3 | 87 | -0.5% |
| Kentucky | $10 | $37 | 23 | 194 | -0.6% |
| North Dakota | $10 | $74 | 6 | 205 | -1.4% |
| Wisconsin | $10 | $84 | 13 | 595 | -1.5% |
| Mississippi | $10 | $91 | 5 | 30 | -2.2% |
| Washington | $10 | $69 | 48 | 1,127 | -3.5% |
| Louisiana | $9 | $71 | 4 | 155 | -7.0% |
⚠️ 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