87449

Detection test by immunoassay technique for other organism

Medicare pricing data for 744 providers across 42 states

🤖AI Overview

This procedure has a 8.2x markup — hospitals charge $95.90 but Medicare allows only $11.73. Uninsured patients may face bills 8.2 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 other organism (HCPCS code 87449) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.73, but hospitals typically charge $95.90 — a 8.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.73, your out-of-pocket cost would be approximately $2.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.73
Average Hospital Charge
$95.90
Markup Ratio
8.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$95.90
Medicare Allowed$11.73
Medicare Payment$11.73

Hospitals charge 8.2x more than what Medicare allows for this procedure. Medicare actually pays $11.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$12$24251+0.1%
Florida$12$1353515,599+0.1%
Idaho$12$30321+0.1%
Iowa$12$158634+0.1%
Kansas$12$14011665+0.1%
Maryland$12$33926,813+0.1%
Massachusetts$12$141136,173+0.1%
Michigan$12$48964+0.1%
Minnesota$12$11843402+0.1%
Missouri$12$141143,896+0.1%
New Jersey$12$1291111,409+0.1%
New Mexico$12$1014209+0.1%
Oregon$12$5233106+0.1%
Rhode Island$12$411119+0.1%
Texas$12$635217,003+0.1%
West Virginia$12$38175+0.1%
Wyoming$12$58427+0.1%
Alabama$12$4611199+0.1%
Georgia$12$16031,4980.0%
Illinois$12$123123,5670.0%
Nevada$12$15039890.0%
New York$12$132111,9040.0%
Pennsylvania$12$13292,1410.0%
California$12$1343814,1170.0%
Colorado$12$12977410.0%
North Carolina$12$104125,305-0.1%
Ohio$12$65331,287-0.1%
Oklahoma$12$110141,884-0.1%
Arizona$12$985564-0.1%
Hawaii$12$453413-0.2%
Tennessee$12$5810832-0.2%
Arkansas$12$246359-0.2%
Mississippi$12$358191-0.3%
Indiana$12$878260-0.3%
Kentucky$12$3658400-0.4%
Louisiana$12$4523241-0.4%
Utah$12$514385-0.4%
Virginia$12$4511786-0.5%
Washington$12$1131621,938-0.6%
Wisconsin$12$61111,218-0.9%
Nebraska$11$31725-3.2%
South Carolina$11$24746-4.0%

⚠️ 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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