87102

Fungal culture (mold or yeast)

Medicare pricing data for 525 providers across 38 states

🤖AI Overview

This procedure has a 9.2x markup — hospitals charge $75.47 but Medicare allows only $8.22. Uninsured patients may face bills 9.2 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

Fungal culture (mold or yeast) (HCPCS code 87102) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.22, but hospitals typically charge $75.47 — a 9.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.64

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.22, your out-of-pocket cost would be approximately $1.64. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.22
Average Hospital Charge
$75.47
Markup Ratio
9.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$75.47
Medicare Allowed$8.22
Medicare Payment$8.22

Hospitals charge 9.2x more than what Medicare allows for this procedure. Medicare actually pays $8.22 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$8$1135580+0.2%
Hawaii$8$453292+0.2%
Idaho$8$67132+0.2%
Illinois$8$8591,167+0.2%
Indiana$8$78272+0.2%
Kansas$8$10010881+0.2%
Kentucky$8$27261+0.2%
Maine$8$50259+0.2%
Maryland$8$1066327+0.2%
Massachusetts$8$72611,084+0.2%
Michigan$8$34889+0.2%
Mississippi$8$642593+0.2%
Missouri$8$1262242+0.2%
Nebraska$8$30266+0.2%
New Jersey$8$10892,639+0.2%
New Mexico$8$702163+0.2%
North Dakota$8$54583+0.2%
Oregon$8$463198+0.2%
Pennsylvania$8$1165529+0.2%
South Dakota$8$813119+0.2%
Tennessee$8$1437689+0.2%
Colorado$8$50545+0.2%
North Carolina$8$4395,824+0.1%
Texas$8$114501,914+0.1%
California$8$60496,780+0.1%
Florida$8$102193,7330.0%
Nevada$8$11514600.0%
New York$8$77141,3550.0%
Ohio$8$49114480.0%
Utah$8$38132440.0%
Iowa$8$577297-0.1%
Oklahoma$8$923731-0.1%
Arizona$8$5771,583-0.1%
Minnesota$8$71781,133-0.6%
Virginia$8$338470-0.9%
Alabama$8$309174-0.9%
Washington$8$2960298-1.2%
Wisconsin$8$718432-2.7%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber