Detection test by nucleic acid for cytomegalovirus, quantification
Medicare pricing data for 258 providers across 33 states
This procedure has a 10.1x markup — hospitals charge $422.10 but Medicare allows only $41.87. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. 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, quantification (HCPCS code 87497) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.87, but hospitals typically charge $422.10 — a 10.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.87, your out-of-pocket cost would be approximately $8.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $41.87 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $42 | $555 | 8 | 10,707 | +1.3% |
| Kentucky | $42 | $127 | 2 | 42 | +0.3% |
| Massachusetts | $42 | $424 | 5 | 2,413 | +0.3% |
| Michigan | $42 | $178 | 5 | 125 | +0.3% |
| New Mexico | $42 | $309 | 2 | 337 | +0.3% |
| South Dakota | $42 | $271 | 5 | 182 | +0.3% |
| Tennessee | $42 | $207 | 5 | 505 | +0.3% |
| Utah | $42 | $168 | 6 | 102 | +0.3% |
| Colorado | $42 | $393 | 5 | 359 | +0.3% |
| Alabama | $42 | $455 | 3 | 1,605 | +0.2% |
| New Jersey | $42 | $429 | 5 | 12,733 | +0.2% |
| New York | $42 | $501 | 6 | 3,070 | +0.2% |
| Washington | $42 | $390 | 9 | 1,204 | +0.2% |
| Pennsylvania | $42 | $365 | 6 | 1,623 | +0.2% |
| California | $42 | $390 | 27 | 14,221 | +0.2% |
| Texas | $42 | $360 | 13 | 6,287 | +0.1% |
| Georgia | $42 | $436 | 4 | 1,222 | -0.0% |
| Maryland | $42 | $384 | 5 | 1,324 | -0.0% |
| Hawaii | $42 | $179 | 2 | 527 | -0.1% |
| Kansas | $42 | $424 | 6 | 2,634 | -0.1% |
| Illinois | $42 | $425 | 6 | 797 | -0.3% |
| Minnesota | $42 | $506 | 36 | 2,550 | -0.3% |
| Oklahoma | $42 | $359 | 4 | 519 | -0.4% |
| Arizona | $42 | $444 | 3 | 4,378 | -0.7% |
| Oregon | $42 | $240 | 5 | 455 | -0.8% |
| Virginia | $42 | $120 | 8 | 1,570 | -0.9% |
| Nevada | $42 | $435 | 2 | 765 | -0.9% |
| North Carolina | $42 | $460 | 7 | 9,014 | -0.9% |
| Ohio | $41 | $266 | 13 | 1,966 | -1.5% |
| Wisconsin | $41 | $367 | 6 | 1,430 | -2.0% |
| Iowa | $40 | $149 | 4 | 176 | -3.6% |
| Indiana | $40 | $264 | 5 | 33 | -4.1% |
| Maine | $40 | $215 | 2 | 150 | -5.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber