Culture for acid-fast bacilli
Medicare pricing data for 271 providers across 38 states
This procedure has a 8.3x markup — hospitals charge $87.80 but Medicare allows only $10.54. Uninsured patients may face bills 8.3 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
Culture for acid-fast bacilli (HCPCS code 87116) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.54, but hospitals typically charge $87.80 — a 8.3x 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 $10.54, your out-of-pocket cost would be approximately $2.11. 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 8.3x more than what Medicare allows for this procedure. Medicare actually pays $10.54 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $11 | $86 | 1 | 481 | +0.4% |
| Indiana | $11 | $98 | 1 | 44 | +0.4% |
| Iowa | $11 | $52 | 7 | 110 | +0.4% |
| Kentucky | $11 | $33 | 1 | 41 | +0.4% |
| Louisiana | $11 | $29 | 2 | 36 | +0.4% |
| Maine | $11 | $88 | 1 | 92 | +0.4% |
| Maryland | $11 | $84 | 5 | 330 | +0.4% |
| Nebraska | $11 | $30 | 1 | 25 | +0.4% |
| New Mexico | $11 | $106 | 1 | 112 | +0.4% |
| North Dakota | $11 | $79 | 3 | 21 | +0.4% |
| Ohio | $11 | $82 | 10 | 608 | +0.4% |
| Pennsylvania | $11 | $149 | 5 | 242 | +0.4% |
| Rhode Island | $11 | $31 | 2 | 26 | +0.4% |
| South Dakota | $11 | $84 | 3 | 60 | +0.4% |
| Tennessee | $11 | $211 | 3 | 404 | +0.4% |
| Utah | $11 | $31 | 5 | 124 | +0.4% |
| Washington | $11 | $97 | 6 | 451 | +0.4% |
| Puerto Rico | $11 | $11 | 5 | 18 | +0.4% |
| Colorado | $11 | $76 | 4 | 47 | +0.4% |
| Florida | $11 | $95 | 16 | 4,160 | +0.3% |
| Hawaii | $11 | $40 | 2 | 1,198 | +0.3% |
| Kansas | $11 | $92 | 7 | 707 | +0.3% |
| Nevada | $11 | $87 | 1 | 660 | +0.3% |
| New York | $11 | $111 | 8 | 1,465 | +0.3% |
| North Carolina | $11 | $98 | 4 | 4,387 | +0.3% |
| Texas | $11 | $92 | 14 | 3,083 | +0.3% |
| Arizona | $11 | $58 | 3 | 1,042 | +0.3% |
| Alabama | $11 | $110 | 4 | 961 | +0.2% |
| California | $11 | $66 | 41 | 5,996 | +0.2% |
| Oklahoma | $11 | $79 | 3 | 268 | +0.1% |
| Illinois | $11 | $100 | 2 | 234 | 0.0% |
| New Jersey | $11 | $96 | 8 | 2,970 | -0.1% |
| Massachusetts | $11 | $83 | 3 | 387 | -0.2% |
| Virginia | $11 | $41 | 8 | 559 | -0.2% |
| Oregon | $11 | $46 | 4 | 128 | -0.3% |
| Mississippi | $10 | $66 | 4 | 68 | -0.6% |
| Wisconsin | $10 | $90 | 7 | 642 | -2.5% |
| Minnesota | $10 | $123 | 51 | 1,142 | -3.4% |
⚠️ 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