Stool culture, additional pathogens
Medicare pricing data for 1,189 providers across 43 states
This procedure has a 5.6x markup — hospitals charge $51.70 but Medicare allows only $9.23. Uninsured patients may face bills 5.6 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
Stool culture, additional pathogens (HCPCS code 87046) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.23, but hospitals typically charge $51.70 — a 5.6x 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 $9.23, your out-of-pocket cost would be approximately $1.85. 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 5.6x more than what Medicare allows for this procedure. Medicare actually pays $9.23 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $9 | $77 | 7 | 221 | +0.2% |
| Indiana | $9 | $18 | 2 | 198 | +0.2% |
| Iowa | $9 | $33 | 6 | 790 | +0.2% |
| Kansas | $9 | $37 | 7 | 282 | +0.2% |
| Louisiana | $9 | $61 | 17 | 397 | +0.2% |
| Maryland | $9 | $61 | 7 | 284 | +0.2% |
| Michigan | $9 | $25 | 6 | 50 | +0.2% |
| Missouri | $9 | $73 | 5 | 139 | +0.2% |
| Nebraska | $9 | $20 | 1 | 91 | +0.2% |
| Nevada | $9 | $72 | 3 | 85 | +0.2% |
| New Hampshire | $9 | $30 | 43 | 95 | +0.2% |
| Rhode Island | $9 | $58 | 1 | 199 | +0.2% |
| Utah | $9 | $39 | 5 | 214 | +0.2% |
| Arkansas | $9 | $26 | 25 | 84 | +0.2% |
| New York | $9 | $35 | 144 | 7,475 | +0.1% |
| North Carolina | $9 | $51 | 12 | 28,314 | +0.1% |
| Ohio | $9 | $52 | 9 | 4,959 | +0.1% |
| Tennessee | $9 | $39 | 7 | 1,462 | +0.1% |
| Texas | $9 | $60 | 61 | 8,651 | +0.1% |
| Arizona | $9 | $60 | 37 | 9,310 | +0.1% |
| Florida | $9 | $61 | 22 | 6,499 | 0.0% |
| Massachusetts | $9 | $60 | 268 | 1,221 | 0.0% |
| New Jersey | $9 | $62 | 13 | 9,831 | 0.0% |
| California | $9 | $60 | 67 | 8,352 | 0.0% |
| Hawaii | $9 | $31 | 2 | 1,285 | -0.1% |
| Maine | $9 | $18 | 3 | 248 | -0.1% |
| Virginia | $9 | $43 | 25 | 2,498 | -0.1% |
| Kentucky | $9 | $28 | 39 | 766 | -0.2% |
| Oklahoma | $9 | $32 | 7 | 866 | -0.2% |
| Oregon | $9 | $19 | 35 | 3,599 | -0.2% |
| South Dakota | $9 | $50 | 20 | 718 | -0.2% |
| Mississippi | $9 | $98 | 12 | 352 | -0.3% |
| Colorado | $9 | $56 | 11 | 135 | -0.3% |
| Pennsylvania | $9 | $67 | 9 | 515 | -0.4% |
| Wisconsin | $9 | $45 | 6 | 1,874 | -0.4% |
| Alabama | $9 | $59 | 16 | 5,505 | -0.4% |
| Illinois | $9 | $44 | 19 | 788 | -0.5% |
| Minnesota | $9 | $51 | 35 | 264 | -0.5% |
| Puerto Rico | $9 | $10 | 11 | 19 | -0.5% |
| North Dakota | $9 | $40 | 13 | 373 | -1.2% |
| Washington | $9 | $47 | 132 | 2,935 | -2.3% |
| Connecticut | $9 | $41 | 3 | 60 | -2.5% |
| South Carolina | $9 | $18 | 7 | 61 | -2.9% |
⚠️ 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