87207

Special stain for inclusion bodies or parasites

Medicare pricing data for 181 providers across 29 states

🤖AI Overview

This procedure has a 11.5x markup — hospitals charge $67.50 but Medicare allows only $5.87. Uninsured patients may face bills 11.5 times higher than what insurance negotiates. Prices vary significantly by location — from $6 in Washington to $18 in Connecticut. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 stain for inclusion bodies or parasites (HCPCS code 87207) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.87, but hospitals typically charge $67.50 — a 11.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.17

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.87, your out-of-pocket cost would be approximately $1.17. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.87
Average Hospital Charge
$67.50
Markup Ratio
11.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$67.50
Medicare Allowed$5.87
Medicare Payment$5.87

Hospitals charge 11.5x more than what Medicare allows for this procedure. Medicare actually pays $5.87 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$18$48827+210.2%
New Hampshire$18$75222+201.2%
Maine$17$20411+197.8%
Iowa$17$96514+188.1%
Oklahoma$7$70518+20.6%
Virginia$7$39516+14.1%
Massachusetts$6$1368461+0.5%
Florida$6$70144580.0%
Georgia$6$7221320.0%
Illinois$6$812290.0%
Kansas$6$1245200.0%
Maryland$6$825820.0%
Minnesota$6$4619830.0%
Missouri$6$492520.0%
Montana$6$322110.0%
Nevada$6$771180.0%
New York$6$7171370.0%
Ohio$6$817210.0%
Pennsylvania$6$62121100.0%
Rhode Island$6$831530.0%
Texas$6$7393160.0%
Alabama$6$722160.0%
Arizona$6$472630.0%
Colorado$6$1183190.0%
New Jersey$6$5962,559-0.2%
North Carolina$6$474572-0.2%
California$6$8215352-0.5%
Mississippi$6$404168-0.7%
Washington$6$76543-2.4%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber