87486

Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique

Medicare pricing data for 571 providers across 38 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 nucleic acid for chlamydia pneumoniae, amplified probe technique (HCPCS code 87486) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.36, but hospitals typically charge $60.25 — a 1.8x 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
$60.25
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$60.25
Medicare Allowed$34.36
Medicare Payment$34.36

Hospitals charge 1.8x 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
Delaware$34$49117+0.1%
District of Columbia$34$351111+0.1%
Florida$34$63558,064+0.1%
Georgia$34$535171+0.1%
Idaho$34$42215+0.1%
Illinois$34$47142,395+0.1%
Indiana$34$535509+0.1%
Kansas$34$88472+0.1%
Maryland$34$746312+0.1%
Michigan$34$5910122+0.1%
Minnesota$34$1081928+0.1%
Mississippi$34$6413727+0.1%
Nebraska$34$608102+0.1%
Nevada$34$865422+0.1%
New Mexico$34$1148447+0.1%
North Dakota$34$122127+0.1%
Pennsylvania$34$51127,899+0.1%
Tennessee$34$43331+0.1%
Utah$34$1051170+0.1%
Wisconsin$34$10552,945+0.1%
Arizona$34$5151,262+0.1%
Arkansas$34$504286+0.1%
New Jersey$34$88277,692+0.1%
California$34$506540,250+0.1%
New York$34$711616,834+0.0%
Texas$34$6110961,148+0.0%
Colorado$34$3941,231+0.0%
Oklahoma$34$43103,989-0.0%
North Carolina$34$515430-0.1%
Ohio$34$6722493-0.1%
Virginia$34$614400-0.1%
Kentucky$34$1026186-0.4%
Missouri$34$5321,546-0.4%
Oregon$34$6324158-0.5%
Louisiana$34$7521936-0.6%
Washington$34$5122267-1.3%
Alabama$33$45321,787-3.9%
South Carolina$32$47517-5.8%

⚠️ 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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