87106

Fungal culture, yeast

Medicare pricing data for 461 providers across 36 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $59.81 but Medicare allows only $10.10. Uninsured patients may face bills 5.9 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, yeast (HCPCS code 87106) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.10, but hospitals typically charge $59.81 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.02

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $10.10, your out-of-pocket cost would be approximately $2.02. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$10.10
Average Hospital Charge
$59.81
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$59.81
Medicare Allowed$10.10
Medicare Payment$10.10

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $10.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$10$597677+0.1%
Hawaii$10$713202+0.1%
Illinois$10$524544+0.1%
Iowa$10$438109+0.1%
Kansas$10$668309+0.1%
Kentucky$10$27241+0.1%
Louisiana$10$46725+0.1%
Maryland$10$685307+0.1%
Mississippi$10$742117+0.1%
Missouri$10$692141+0.1%
Nebraska$10$30118+0.1%
Nevada$10$582305+0.1%
New Jersey$10$6692,900+0.1%
North Carolina$10$6532,146+0.1%
North Dakota$10$62462+0.1%
Oklahoma$10$444188+0.1%
Oregon$10$2811143+0.1%
Pennsylvania$10$587336+0.1%
South Dakota$10$88395+0.1%
Tennessee$10$566225+0.1%
Texas$10$57221,505+0.1%
Utah$10$54483+0.1%
Arizona$10$604156+0.1%
Arkansas$10$211538+0.1%
Colorado$10$56475+0.1%
Florida$10$58142,7270.0%
Massachusetts$10$63809320.0%
New York$10$32525900.0%
Ohio$10$5812450-0.1%
Alabama$10$526446-0.1%
California$10$65272,524-0.1%
Indiana$10$1272138-0.5%
Washington$10$5246258-0.5%
Wisconsin$10$698631-0.5%
Minnesota$10$6958462-0.6%
Virginia$10$319190-0.8%

⚠️ 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