87184

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)

Medicare pricing data for 1,217 providers across 43 states

🤖AI Overview

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

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) (HCPCS code 87184) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.32, but hospitals typically charge $24.76 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.32, your out-of-pocket cost would be approximately $1.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.32
Average Hospital Charge
$24.76
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$24.76
Medicare Allowed$7.32
Medicare Payment$7.32

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $7.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$7$133225,481+0.1%
Georgia$7$59431+0.1%
Hawaii$7$422154+0.1%
Iowa$7$43461+0.1%
Maryland$7$3015231+0.1%
Massachusetts$7$211351,158+0.1%
Michigan$7$11174+0.1%
Mississippi$7$134415+0.1%
Missouri$7$6110182+0.1%
Nebraska$7$191475+0.1%
Nevada$7$63160+0.1%
New Mexico$7$52232+0.1%
New York$7$35797,900+0.1%
North Dakota$7$29548+0.1%
South Carolina$7$10186+0.1%
South Dakota$7$501077+0.1%
Utah$7$30729+0.1%
Wisconsin$7$6432438+0.1%
Alabama$7$1664,651+0.1%
California$7$2910234,810+0.1%
Colorado$7$21419+0.1%
Connecticut$7$34216+0.1%
Illinois$7$58265,0270.0%
New Jersey$7$141666,6010.0%
Pennsylvania$7$16105,6030.0%
Texas$7$30402,9870.0%
Arizona$7$2058220.0%
North Carolina$7$44511,086-0.1%
Virginia$7$2459376-0.1%
Arkansas$7$3032,790-0.1%
Tennessee$7$21411,446-0.3%
Oklahoma$7$15141,980-0.4%
Puerto Rico$7$838202-0.4%
Kentucky$7$323129-0.5%
Minnesota$7$3371364-0.5%
Oregon$7$237214-0.5%
Louisiana$7$28273,293-0.7%
Ohio$7$499179-0.8%
Wyoming$7$311167-0.8%
Washington$7$32113555-1.1%
Montana$7$38441-1.5%
Maine$7$203889-1.9%
Kansas$7$72323-2.6%

⚠️ 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