87493

Detection test by nucleic acid for clostridium difficile, amplified probe technique

Medicare pricing data for 2,841 providers across 48 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 clostridium difficile, amplified probe technique (HCPCS code 87493) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.41, but hospitals typically charge $116.62 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.41, your out-of-pocket cost would be approximately $7.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.41
Average Hospital Charge
$116.62
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$116.62
Medicare Allowed$36.41
Medicare Payment$36.41

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $36.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$37$69215+0.3%
Kentucky$37$837486+0.3%
Michigan$37$1368113+0.3%
Missouri$37$7557426+0.3%
Nebraska$37$1002190+0.3%
Nevada$37$1125813+0.3%
New Hampshire$37$11148110+0.3%
New Mexico$37$160429+0.3%
Oklahoma$37$1467351+0.3%
Pennsylvania$37$531321,837+0.3%
Rhode Island$37$78249+0.3%
West Virginia$37$137214+0.3%
Wyoming$37$1821642+0.3%
Alaska$37$2641318+0.3%
Kansas$37$153432,829+0.3%
Massachusetts$36$1432682,826+0.2%
Hawaii$36$942693+0.2%
New Jersey$36$1921026,014+0.2%
Ohio$36$991473,677+0.2%
Colorado$36$1339666+0.2%
Georgia$36$15330674+0.2%
Florida$36$134476,125+0.1%
Iowa$36$1339874+0.1%
New York$36$1221174,163+0.1%
Indiana$36$537498+0.1%
North Carolina$36$148625,654+0.1%
Texas$36$1381617,475+0.1%
South Dakota$36$14124337+0.1%
Virginia$36$119452,572+0.0%
Maine$36$7732890.0%
California$36$136437,075-0.1%
Tennessee$36$1331832,675-0.1%
Illinois$36$1062996,681-0.1%
Arizona$36$151482,592-0.1%
Utah$36$7085361-0.2%
Louisiana$36$8537659-0.2%
North Dakota$36$16915460-0.2%
Alabama$36$139201,623-0.4%
Washington$36$1411982,263-0.4%
Oregon$36$94501,131-0.6%
Maryland$36$114411,466-0.7%
Montana$36$88263-0.7%
Wisconsin$36$165492,093-0.9%
Minnesota$36$1404481,750-1.0%
South Carolina$35$1221290-3.9%
Mississippi$35$107891-4.3%
Idaho$34$931457-6.3%
Arkansas$31$4517244-13.7%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber