87502

Detection test by nucleic acid for multiple types influenza virus

Medicare pricing data for 18,146 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 multiple types influenza virus (HCPCS code 87502) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $92.94, but hospitals typically charge $197.22 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $92.94, your out-of-pocket cost would be approximately $18.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$92.94
Average Hospital Charge
$197.22
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$197.22
Medicare Allowed$92.94
Medicare Payment$92.94

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $92.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$94$24436186+1.0%
Puerto Rico$94$96113+1.0%
Wisconsin$94$2882083,378+0.9%
Rhode Island$94$18041226+0.9%
Texas$94$17197747,314+0.8%
Colorado$94$2293471,770+0.7%
Illinois$94$1971,26618,606+0.7%
Florida$94$20574317,893+0.7%
New Jersey$94$1842139,322+0.6%
Connecticut$93$1442471,352+0.6%
District of Columbia$93$14122187+0.5%
North Dakota$93$2471843+0.5%
Utah$93$148160700+0.4%
Maryland$93$1481281,338+0.4%
Missouri$93$2144059,384+0.4%
Massachusetts$93$3057368,212+0.2%
Montana$93$194105614+0.2%
South Dakota$93$16168637+0.2%
Iowa$93$2523562,812+0.2%
Arizona$93$159146760+0.2%
Oregon$93$2103011,257+0.2%
Arkansas$93$1501933,103+0.2%
New York$93$2196919,742+0.2%
Virginia$93$1793322,228+0.1%
Kansas$93$2303492,648+0.1%
Indiana$93$1754212,716+0.0%
New Hampshire$93$382444750.0%
Pennsylvania$93$2176254,207-0.0%
Maine$93$19256466-0.1%
Oklahoma$93$1692654,580-0.1%
Minnesota$93$2244211,001-0.1%
South Carolina$93$2056169,663-0.2%
Hawaii$93$239541,427-0.3%
Nebraska$93$2432231,644-0.3%
Tennessee$93$17190710,321-0.3%
North Carolina$93$2241,74512,328-0.3%
Ohio$93$2497353,120-0.3%
California$93$1891,01547,780-0.3%
Washington$93$2245062,487-0.4%
Idaho$93$174152784-0.4%
Kentucky$92$1802672,951-0.5%
West Virginia$92$21429182-0.5%
Alaska$92$25080496-0.8%
Mississippi$92$21748212,776-0.8%
Georgia$92$1963513,092-1.1%
New Mexico$92$14894943-1.5%
Wyoming$92$12334200-1.5%
Michigan$90$1372502,082-2.6%
Alabama$90$1352262,239-3.2%
Louisiana$89$1654356,219-4.2%

⚠️ 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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