87075

Bacterial culture, any source, except blood, anaerobic

Medicare pricing data for 736 providers across 42 states

🤖AI Overview

This procedure has a 9.7x markup — hospitals charge $90.30 but Medicare allows only $9.27. Uninsured patients may face bills 9.7 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 culture, any source, except blood, anaerobic (HCPCS code 87075) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.27, but hospitals typically charge $90.30 — a 9.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.27, 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.

Average Allowed Cost
$9.27
Average Hospital Charge
$90.30
Markup Ratio
9.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$90.30
Medicare Allowed$9.27
Medicare Payment$9.27

Hospitals charge 9.7x more than what Medicare allows for this procedure. Medicare actually pays $9.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$9$1103322,144+0.1%
Illinois$9$89237,499+0.1%
Kentucky$9$374324+0.1%
Louisiana$9$915562+0.1%
Maine$9$732142+0.1%
Maryland$9$33109,936+0.1%
Massachusetts$9$116313,186+0.1%
Mississippi$9$437278+0.1%
Nebraska$9$401309+0.1%
Nevada$9$1145842+0.1%
New Mexico$9$522669+0.1%
Pennsylvania$9$7792,233+0.1%
Connecticut$9$61533+0.1%
Georgia$9$463814,9000.0%
Hawaii$9$4021,2960.0%
Kansas$9$104124,4290.0%
Missouri$9$12091,0130.0%
New Jersey$9$1061015,1040.0%
New York$9$55904,7120.0%
North Carolina$9$901019,3510.0%
Texas$9$1176513,5150.0%
Colorado$9$11882,6790.0%
Iowa$9$3930630-0.1%
Michigan$9$6710353-0.1%
Ohio$9$95175,150-0.1%
Tennessee$9$110211,564-0.1%
Utah$9$949665-0.1%
Washington$9$92404,957-0.1%
Alabama$9$119216,015-0.1%
Arizona$9$9644,346-0.1%
California$9$1004215,222-0.1%
Oklahoma$9$109122,736-0.2%
Oregon$9$274580-0.2%
Minnesota$9$7069725-0.3%
Virginia$9$586906-0.3%
South Dakota$9$666489-0.4%
North Dakota$9$569169-0.8%
Wisconsin$9$82113,066-1.5%
Indiana$9$535286-1.7%
Idaho$9$39488-3.3%
South Carolina$9$521245-7.8%
West Virginia$8$116318-10.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

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