87480

Detection test for candida species (yeast), direct probe technique

Medicare pricing data for 2,184 providers across 45 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 for candida species (yeast), direct probe technique (HCPCS code 87480) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.57, but hospitals typically charge $84.33 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.91

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.57, your out-of-pocket cost would be approximately $3.91. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.57
Average Hospital Charge
$84.33
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$84.33
Medicare Allowed$19.57
Medicare Payment$19.57

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $19.57 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maine$20$6264161+0.4%
Maryland$20$1107426+0.4%
Michigan$20$457176+0.4%
New Hampshire$20$353209+0.4%
Ohio$20$89141,253+0.4%
Oklahoma$20$632163+0.4%
Rhode Island$20$49225+0.4%
Tennessee$20$715261+0.4%
Utah$20$6163455+0.4%
Wyoming$20$74420+0.4%
Alaska$20$11941104+0.4%
New Jersey$20$108483,910+0.4%
Florida$20$81122,360+0.3%
California$20$83454,112+0.3%
Hawaii$20$532418+0.2%
North Dakota$20$815221+0.2%
Arizona$20$74381,866+0.2%
South Carolina$20$1201498+0.2%
Virginia$20$7819432+0.2%
Pennsylvania$20$68251,168+0.1%
Texas$20$99823,298+0.1%
Illinois$20$1121881,4430.0%
Massachusetts$20$104531,0660.0%
North Carolina$20$881381,5610.0%
Indiana$20$933623-0.1%
Kansas$20$7265984-0.1%
Washington$20$114271,091-0.1%
Oregon$20$491111,425-0.2%
New York$20$791613,587-0.3%
Nebraska$20$5055493-0.4%
Iowa$19$67127868-0.4%
Wisconsin$19$13170175-0.5%
Minnesota$19$734091,602-0.5%
Mississippi$19$7168858-0.6%
Colorado$19$7124340-0.6%
South Dakota$19$292499-0.6%
Missouri$19$491975-0.7%
Idaho$19$5626152-0.8%
Alabama$19$1141283-0.8%
West Virginia$19$37781-0.8%
Connecticut$19$7412714-0.9%
Louisiana$19$56856-1.2%
Nevada$19$8860538-1.2%
Arkansas$19$481884-2.0%
Montana$19$453114-2.2%

⚠️ 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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