87209

Special stain for parasites

Medicare pricing data for 694 providers across 45 states

🤖AI Overview

This procedure has a 5.0x markup — hospitals charge $88.28 but Medicare allows only $17.56. Uninsured patients may face bills 5.0 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 stain for parasites (HCPCS code 87209) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.56, but hospitals typically charge $88.28 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.56, your out-of-pocket cost would be approximately $3.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.56
Average Hospital Charge
$88.28
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$88.28
Medicare Allowed$17.56
Medicare Payment$17.56

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $17.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$18$11861,203+0.5%
Georgia$18$1425171+0.3%
Illinois$18$111151,705+0.3%
Iowa$18$477232+0.3%
Kansas$18$837112+0.3%
Kentucky$18$47493+0.3%
Louisiana$18$593137+0.3%
Maine$18$781120+0.3%
Missouri$18$122131,168+0.3%
Nebraska$18$50178+0.3%
Nevada$18$1182852+0.3%
New Hampshire$18$582343+0.3%
New Mexico$18$1172150+0.3%
North Dakota$18$74319+0.3%
Rhode Island$18$321183+0.3%
South Carolina$18$35546+0.3%
Tennessee$18$6171,009+0.3%
Utah$18$66237+0.3%
Wyoming$18$55113+0.3%
Puerto Rico$18$18440+0.3%
Connecticut$18$1222571+0.3%
North Carolina$18$721618,189+0.3%
Massachusetts$18$120113,592+0.2%
Pennsylvania$18$10681,287+0.2%
Texas$18$9214610,728+0.2%
Arizona$18$7448,340+0.2%
Arkansas$18$3611805+0.2%
Colorado$18$11951,001+0.2%
New Jersey$18$741523,037+0.2%
Ohio$18$66983,398+0.1%
Oklahoma$18$979870+0.1%
California$18$1155215,419+0.1%
Florida$18$1082212,397-0.1%
New York$18$14771,515-0.1%
Alabama$18$74134,677-0.1%
Hawaii$18$962911-0.1%
Washington$18$87103,395-0.2%
Minnesota$18$111108970-0.3%
Wisconsin$18$528675-0.3%
Mississippi$17$946139-0.4%
Oregon$17$425954-0.5%
South Dakota$17$933111-1.1%
Indiana$17$46255-1.4%
Virginia$16$5442,200-6.4%
Michigan$16$319102-6.8%

⚠️ 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