87491

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

Medicare pricing data for 3,672 providers across 50 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 trachomatis, amplified probe technique (HCPCS code 87491) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.33, but hospitals typically charge $92.05 — a 2.7x 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 $34.33, 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
$34.33
Average Hospital Charge
$92.05
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$92.05
Medicare Allowed$34.33
Medicare Payment$34.33

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $34.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$34$831145+0.2%
Maine$34$6134154+0.2%
Montana$34$881554+0.2%
Nebraska$34$6520342+0.2%
Rhode Island$34$904110+0.2%
Wyoming$34$791842+0.2%
Massachusetts$34$1062895,665+0.1%
Pennsylvania$34$542914,173+0.1%
Louisiana$34$78851,584+0.1%
Missouri$34$78411,689+0.1%
New York$34$1932619,099+0.1%
Utah$34$103501,864+0.1%
California$34$9124733,662+0.1%
Georgia$34$107271,301+0.1%
Texas$34$6430038,912+0.1%
West Virginia$34$11841,763+0.1%
New Jersey$34$1264530,058+0.1%
Arizona$34$667011,976+0.1%
Illinois$34$809010,541+0.0%
Oklahoma$34$58428,1750.0%
Florida$34$939220,692-0.0%
Kansas$34$98803,128-0.0%
Puerto Rico$34$4444485-0.0%
Maryland$34$91552,615-0.1%
Michigan$34$64343,066-0.1%
Colorado$34$103401,109-0.1%
Hawaii$34$915350-0.1%
North Carolina$34$120938,347-0.1%
Tennessee$34$111731,240-0.3%
Virginia$34$72391,641-0.3%
Kentucky$34$9237331-0.4%
Indiana$34$5335636-0.4%
Ohio$34$113581,618-0.4%
Alabama$34$121562,982-0.4%
South Dakota$34$19019121-0.5%
Arkansas$34$8379420-0.5%
Minnesota$34$1484911,302-0.6%
Nevada$34$10747940-0.6%
New Mexico$34$11112218-0.6%
Iowa$34$8250231-0.6%
Oregon$34$7198863-0.6%
Connecticut$34$12523205-0.7%
South Carolina$34$8942285-0.8%
Mississippi$34$9455421-1.0%
Washington$34$741652,772-1.3%
Idaho$34$821663-1.4%
Alaska$34$1643461-1.5%
Wisconsin$34$15971799-2.0%
North Dakota$34$1222373-2.4%
New Hampshire$33$7012114-3.3%

⚠️ 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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