87496

Detection test by nucleic acid for cytomegalovirus (cmv), amplified probe technique

Medicare pricing data for 309 providers across 30 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 cytomegalovirus (cmv), amplified probe technique (HCPCS code 87496) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.36, but hospitals typically charge $80.17 — a 2.3x 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
$80.17
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$80.17
Medicare Allowed$34.36
Medicare Payment$34.36

Hospitals charge 2.3x 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
Georgia$34$378293+0.1%
Hawaii$34$454232+0.1%
Indiana$34$413479+0.1%
Iowa$34$718238+0.1%
Kansas$34$378452+0.1%
Louisiana$34$98387+0.1%
Maryland$34$994176+0.1%
Massachusetts$34$380380+0.1%
Minnesota$34$269319+0.1%
Nevada$34$195332+0.1%
New York$34$306650+0.1%
North Carolina$34$3711588+0.1%
Ohio$34$1204433+0.1%
Oklahoma$34$1235261+0.1%
Oregon$34$250324+0.1%
Tennessee$34$283423+0.1%
Utah$34$1055200+0.1%
Washington$34$776775+0.1%
Wisconsin$34$99221+0.1%
Alabama$34$3576172+0.1%
Arizona$34$5658,290+0.1%
Florida$34$110194,670+0.1%
New Jersey$34$159232,374+0.0%
Texas$34$5810120,856+0.0%
Illinois$34$54233,2950.0%
California$34$291134730.0%
Pennsylvania$34$1089410-0.1%
Missouri$34$5431,494-0.5%
Colorado$34$15022198-0.8%
Virginia$34$716153-1.0%

⚠️ 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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