Detection of babesia microtim by amplified nucleic acid probe technique
Medicare pricing data for 149 providers across 21 states
This procedure has a 12.6x markup — hospitals charge $434.73 but Medicare allows only $34.37. Uninsured patients may face bills 12.6 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 babesia microtim by amplified nucleic acid probe technique (HCPCS code 87469) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.37, but hospitals typically charge $434.73 — a 12.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.37, 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.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 12.6x more than what Medicare allows for this procedure. Medicare actually pays $34.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Illinois | $34 | $475 | 1 | 61 | +0.1% |
| Kansas | $34 | $478 | 3 | 149 | +0.1% |
| Maryland | $34 | $477 | 2 | 30 | +0.1% |
| Massachusetts | $34 | $479 | 7 | 3,395 | +0.1% |
| New Hampshire | $34 | $36 | 38 | 92 | +0.1% |
| New Jersey | $34 | $478 | 5 | 2,268 | +0.1% |
| New York | $34 | $413 | 27 | 1,352 | +0.1% |
| North Carolina | $34 | $494 | 3 | 379 | +0.1% |
| Ohio | $34 | $484 | 2 | 17 | +0.1% |
| Pennsylvania | $34 | $446 | 5 | 253 | +0.1% |
| Rhode Island | $34 | $140 | 1 | 61 | +0.1% |
| Tennessee | $34 | $124 | 2 | 113 | +0.1% |
| Texas | $34 | $205 | 4 | 21 | +0.1% |
| Utah | $34 | $70 | 1 | 15 | +0.1% |
| Virginia | $34 | $275 | 3 | 16 | +0.1% |
| California | $34 | $490 | 4 | 37 | +0.1% |
| Minnesota | $34 | $96 | 8 | 82 | -0.1% |
| Maine | $34 | $87 | 3 | 296 | -0.2% |
| Wisconsin | $34 | $92 | 8 | 53 | -1.8% |
| Florida | $34 | $479 | 4 | 50 | -1.9% |
| Oklahoma | $33 | $302 | 3 | 41 | -3.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber