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Detection of anaplasma phagocytophilum by amplified nucleic acid probe technique

Medicare pricing data for 162 providers across 23 states

🤖AI Overview

This procedure has a 10.1x markup — hospitals charge $347.88 but Medicare allows only $34.36. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 of anaplasma phagocytophilum by amplified nucleic acid probe technique (HCPCS code 87468) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.36, but hospitals typically charge $347.88 — a 10.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.36, your out-of-pocket cost would be approximately $6.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.36
Average Hospital Charge
$347.88
Markup Ratio
10.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$347.88
Medicare Allowed$34.36
Medicare Payment$34.36

Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $34.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$34$437118+0.1%
Illinois$34$445150+0.1%
Kansas$34$4392147+0.1%
Maryland$34$446233+0.1%
Massachusetts$34$45083,196+0.1%
New Hampshire$34$363892+0.1%
New Jersey$34$35142,083+0.1%
Ohio$34$278446+0.1%
Pennsylvania$34$4105267+0.1%
Rhode Island$34$70163+0.1%
Tennessee$34$1253188+0.1%
Texas$34$187538+0.1%
Utah$34$70111+0.1%
Virginia$34$281216+0.1%
Alabama$34$238117+0.1%
California$34$424429+0.1%
New York$34$321311,335+0.0%
North Carolina$34$25131,0310.0%
Maine$34$853295-0.3%
Minnesota$34$1159115-0.7%
Wisconsin$34$10411109-1.7%
Florida$33$426432-3.0%
Oklahoma$33$291240-4.0%

⚠️ 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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