87400

Detection test by immunoassay technique for influenza virus

Medicare pricing data for 4,563 providers across 52 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

Detection test by immunoassay technique for influenza virus (HCPCS code 87400) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.75, but hospitals typically charge $45.24 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.75, your out-of-pocket cost would be approximately $2.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$13.75
Average Hospital Charge
$45.24
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$45.24
Medicare Allowed$13.75
Medicare Payment$13.75

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $13.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Idaho$14$3714255+0.7%
Maine$14$511078+0.7%
Montana$14$4247230+0.7%
Nebraska$14$4818134+0.7%
New Mexico$14$291042+0.7%
New York$14$6169637+0.7%
North Dakota$14$34482+0.7%
Oregon$14$3040400+0.7%
Rhode Island$14$4825245+0.7%
South Dakota$14$61822+0.7%
Utah$14$2826101+0.7%
Vermont$14$5818412+0.7%
Washington$14$3443313+0.7%
Wisconsin$14$7286327+0.7%
Wyoming$14$3419509+0.7%
Puerto Rico$14$161792+0.7%
Arizona$14$5454149+0.7%
California$14$841155,657+0.7%
Connecticut$14$73968+0.7%
Illinois$14$19545,755+0.7%
Massachusetts$14$533794,384+0.5%
New Jersey$14$4738499+0.5%
Florida$14$742292,937+0.4%
Missouri$14$491801,048+0.4%
Maryland$14$4915617,060+0.4%
New Hampshire$14$58721,143+0.4%
Virginia$14$39802,374+0.4%
Colorado$14$3861504+0.4%
Georgia$14$412353,421+0.3%
Iowa$14$4630205+0.3%
Delaware$14$497882+0.1%
District of Columbia$14$4910980+0.1%
South Carolina$14$45961,067+0.1%
Nevada$14$36101050.0%
Oklahoma$14$293384,9190.0%
Indiana$14$382351,913-0.1%
Pennsylvania$14$4835491-0.1%
Texas$14$395057,259-0.1%
Arkansas$14$372253,241-0.1%
North Carolina$14$40791,248-0.1%
Alaska$14$58868-0.1%
Mississippi$14$491523,833-0.6%
Alabama$14$31941,272-0.7%
Kansas$14$593295-0.7%
Michigan$14$2883287-1.1%
Minnesota$14$4115102-1.3%
Hawaii$13$43569-1.9%
Kentucky$13$351853,819-2.1%
West Virginia$13$401672-2.7%
Louisiana$13$3351403-2.8%
Tennessee$13$321671,944-3.1%
Ohio$13$3268605-8.6%

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

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