87206

Special fluorescent and/or acid fast stain for microorganism

Medicare pricing data for 331 providers across 41 states

🤖AI Overview

This procedure has a 9.7x markup — hospitals charge $51.03 but Medicare allows only $5.28. Uninsured patients may face bills 9.7 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

Special fluorescent and/or acid fast stain for microorganism (HCPCS code 87206) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.28, but hospitals typically charge $51.03 — a 9.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.28, your out-of-pocket cost would be approximately $1.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.28
Average Hospital Charge
$51.03
Markup Ratio
9.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$51.03
Medicare Allowed$5.28
Medicare Payment$5.28

Hospitals charge 9.7x more than what Medicare allows for this procedure. Medicare actually pays $5.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$6$64501,546+5.7%
Mississippi$5$36895+1.5%
Oregon$5$256169+0.8%
Puerto Rico$5$6719+0.6%
Florida$5$58177,8260.0%
Georgia$5$5639170.0%
Hawaii$5$2121,2440.0%
Indiana$5$5911230.0%
Kansas$5$58101,4210.0%
Kentucky$5$171430.0%
Louisiana$5$353660.0%
Maine$5$1511620.0%
Maryland$5$5656070.0%
Michigan$5$195310.0%
Missouri$5$6811530.0%
Nebraska$5$151250.0%
Nevada$5$5321,0470.0%
New Mexico$5$2412690.0%
New York$5$59101,5970.0%
North Carolina$5$5366,3140.0%
North Dakota$5$703210.0%
Ohio$5$4891,1820.0%
Pennsylvania$5$7163690.0%
Rhode Island$5$122320.0%
South Dakota$5$634650.0%
Tennessee$5$6141,1310.0%
Utah$5$133330.0%
California$5$42339,0270.0%
Colorado$5$434720.0%
Illinois$5$634806-0.2%
Massachusetts$5$516923-0.2%
New Jersey$5$58156,655-0.2%
Oklahoma$5$453506-0.2%
Texas$5$54225,052-0.2%
Washington$5$4820991-0.2%
Alabama$5$5651,713-0.2%
Arizona$5$3641,615-0.4%
Arkansas$5$94129-0.6%
Virginia$5$219797-0.8%
Iowa$5$247204-1.3%
Wisconsin$5$499879-3.4%

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

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