87338

Detection test by immunoassay technique for helicobacter pylori (gi tract bacteria) in stool

Medicare pricing data for 1,072 providers across 45 states

🤖AI Overview

This procedure has a 11.1x markup — hospitals charge $155.67 but Medicare allows only $14.02. Uninsured patients may face bills 11.1 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

Detection test by immunoassay technique for helicobacter pylori (gi tract bacteria) in stool (HCPCS code 87338) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.02, but hospitals typically charge $155.67 — a 11.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.02, your out-of-pocket cost would be approximately $2.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.02
Average Hospital Charge
$155.67
Markup Ratio
11.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$155.67
Medicare Allowed$14.02
Medicare Payment$14.02

Hospitals charge 11.1x more than what Medicare allows for this procedure. Medicare actually pays $14.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$14$199263,937+0.5%
Hawaii$14$481168+0.5%
Idaho$14$47947+0.5%
Indiana$14$903124+0.5%
Iowa$14$1237121+0.5%
Kansas$14$965109+0.5%
Kentucky$14$43357+0.5%
Louisiana$14$223323+0.5%
Maine$14$88367+0.5%
Montana$14$70142+0.5%
Nebraska$14$59229+0.5%
Nevada$14$1795256+0.5%
New Mexico$14$2303420+0.5%
Pennsylvania$14$17610495+0.5%
Rhode Island$14$50157+0.5%
South Carolina$14$68523+0.5%
Utah$14$4917160+0.5%
Wyoming$14$124523+0.5%
Puerto Rico$14$1780196+0.5%
Colorado$14$1664222+0.5%
North Carolina$14$2051910,213+0.4%
Arizona$14$21484,197+0.4%
Maryland$14$1178819+0.4%
Massachusetts$14$1751341,541+0.4%
Missouri$14$2079596+0.4%
New Jersey$14$1023612,387+0.4%
New York$14$138341,060+0.4%
North Dakota$14$68533+0.4%
Texas$14$179482,687+0.4%
Ohio$14$16512572+0.3%
Virginia$14$789816+0.3%
Alabama$14$2076564+0.1%
Oklahoma$14$2279364+0.1%
Arkansas$14$296580-0.1%
Tennessee$14$11510503-0.2%
Washington$14$180221,901-0.4%
Illinois$14$15819793-0.5%
Minnesota$14$57265584-0.7%
Wisconsin$14$13841554-1.1%
California$14$1481119,739-1.1%
Oregon$14$9532734-1.3%
South Dakota$14$1406188-1.7%
Mississippi$14$86774-2.6%
Georgia$12$150766-10.9%
Michigan$11$43950-21.9%

⚠️ 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