87076

Bacterial culture for anaerobic isolates

Medicare pricing data for 340 providers across 36 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $45.82 but Medicare allows only $7.90. Uninsured patients may face bills 5.8 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 for anaerobic isolates (HCPCS code 87076) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.90, but hospitals typically charge $45.82 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.58

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.90, your out-of-pocket cost would be approximately $1.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.90
Average Hospital Charge
$45.82
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$45.82
Medicare Allowed$7.90
Medicare Payment$7.90

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $7.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$8$50184,354+0.3%
Georgia$8$534732+0.3%
Hawaii$8$292279+0.3%
Iowa$8$45796+0.3%
Kentucky$8$27539+0.3%
Louisiana$8$28366+0.3%
Maryland$8$443153+0.3%
Massachusetts$8$506413+0.3%
Michigan$8$27315+0.3%
Mississippi$8$52233+0.3%
Missouri$8$524197+0.3%
Nebraska$8$251110+0.3%
Nevada$8$49289+0.3%
New York$8$2736228+0.3%
North Dakota$8$45338+0.3%
Oregon$8$19264+0.3%
Pennsylvania$8$516354+0.3%
South Dakota$8$53354+0.3%
New Jersey$8$54162,860+0.1%
Ohio$8$588568+0.1%
California$8$48304,044+0.1%
Colorado$8$584545+0.1%
Kansas$8$5598050.0%
North Carolina$8$5431,2770.0%
Oklahoma$8$3746070.0%
Tennessee$8$4673670.0%
Illinois$8$409829-0.1%
Texas$8$33265,027-0.1%
Alabama$8$364659-0.1%
Arizona$8$335457-0.1%
Virginia$8$254172-0.3%
Utah$8$494133-0.4%
Washington$8$4614814-0.5%
Wisconsin$8$708821-0.5%
Minnesota$8$5153128-1.3%
Indiana$8$234172-1.9%

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

Related from TheDataProject.ai

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