87427

Detection test by immunoassay technique for shiga-like toxin (bacterial toxin)

Medicare pricing data for 404 providers across 41 states

🤖AI Overview

This procedure has a 7.8x markup — hospitals charge $91.54 but Medicare allows only $11.69. Uninsured patients may face bills 7.8 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 shiga-like toxin (bacterial toxin) (HCPCS code 87427) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.69, but hospitals typically charge $91.54 — a 7.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.34

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.69, your out-of-pocket cost would be approximately $2.34. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.69
Average Hospital Charge
$91.54
Markup Ratio
7.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.54
Medicare Allowed$11.69
Medicare Payment$11.69

Hospitals charge 7.8x more than what Medicare allows for this procedure. Medicare actually pays $11.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$12$1053010,277+0.4%
Georgia$12$115201,785+0.4%
Iowa$12$303322+0.4%
Kansas$12$726190+0.4%
Kentucky$12$3315386+0.4%
Louisiana$12$7316445+0.4%
Maine$12$33290+0.4%
Massachusetts$12$11832,705+0.4%
Michigan$12$45795+0.4%
Minnesota$12$382237+0.4%
Missouri$12$11752,691+0.4%
Nebraska$12$20192+0.4%
Nevada$12$1191531+0.4%
New Mexico$12$111228+0.4%
New York$12$1068169+0.4%
Oklahoma$12$1047762+0.4%
Pennsylvania$12$1164720+0.4%
Rhode Island$12$251190+0.4%
South Dakota$12$631134+0.4%
Tennessee$12$4691,328+0.4%
Utah$12$38328+0.4%
Wyoming$12$69131+0.4%
Colorado$12$1134381+0.4%
Maryland$12$11051,044+0.3%
New Jersey$12$101910,710+0.3%
North Carolina$12$87911,228+0.3%
Arizona$12$9128,159+0.3%
California$12$97318,599+0.3%
Hawaii$12$481299+0.3%
Oregon$12$6523439+0.3%
Texas$12$83237,722+0.3%
Virginia$12$34141,209+0.3%
Ohio$12$79194,066+0.2%
Illinois$12$111111,505+0.1%
Alabama$12$8284,5210.0%
Wisconsin$12$6541,187-0.5%
Arkansas$12$2426218-0.5%
Mississippi$12$848222-0.7%
Connecticut$11$62257-5.2%
Washington$11$76213,554-7.3%
North Dakota$11$38317-7.5%

⚠️ 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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