87430

Detection test by immunoassay technique for streptococcus, group a (strep)

Medicare pricing data for 3,845 providers across 48 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 streptococcus, group a (strep) (HCPCS code 87430) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.30, but hospitals typically charge $41.22 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $16.30, your out-of-pocket cost would be approximately $3.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$16.30
Average Hospital Charge
$41.22
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$41.22
Medicare Allowed$16.30
Medicare Payment$16.30

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $16.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maine$16$482380+1.0%
Minnesota$16$423160+1.0%
Nebraska$16$3929107+1.0%
North Dakota$16$581227+1.0%
Rhode Island$16$59519+1.0%
South Dakota$16$641343+1.0%
Vermont$16$5319155+1.0%
Puerto Rico$16$63149+1.0%
Alaska$16$103333+1.0%
Arizona$16$4254112+1.0%
Connecticut$16$45919+1.0%
Florida$16$58155804+0.9%
California$16$512281,287+0.8%
Kansas$16$4281349+0.7%
New York$16$431321,308+0.7%
Wyoming$16$7513332+0.7%
Illinois$16$4386269+0.6%
Idaho$16$3041160+0.6%
Virginia$16$331201,226+0.6%
Massachusetts$16$5858510+0.5%
New Hampshire$16$5471674+0.5%
Colorado$16$5280173+0.5%
South Carolina$16$50152857+0.4%
Maryland$16$3427148+0.4%
Arkansas$16$392431,378+0.4%
Missouri$16$41151420+0.3%
Indiana$16$372731,247+0.2%
Mississippi$16$451062,326+0.2%
Texas$16$432491,723+0.2%
Kentucky$16$5563284+0.1%
New Jersey$16$372971,487+0.1%
Oregon$16$5257230+0.1%
Oklahoma$16$362111,8770.0%
Washington$16$3928103-0.1%
Iowa$16$2650267-0.1%
Pennsylvania$16$3043197-0.4%
Louisiana$16$3862205-0.4%
New Mexico$16$311266-0.5%
West Virginia$16$3733496-0.5%
North Carolina$16$37110539-0.6%
Georgia$16$4755502-0.9%
Michigan$16$3937160-0.9%
Alabama$16$21711,855-1.5%
Utah$16$391226-2.1%
Nevada$16$5054169-2.4%
Tennessee$16$35110706-2.6%
Montana$16$522481-2.8%
Ohio$15$2234220-7.0%

⚠️ 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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