87503

Detection test by nucleic acid for multiple types influenza virus, each additional influenza virus type or sub-type

Medicare pricing data for 29 providers across 10 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, each additional influenza virus type or sub-type (HCPCS code 87503) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.64, but hospitals typically charge $36.76 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.64, your out-of-pocket cost would be approximately $5.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.64
Average Hospital Charge
$36.76
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$36.76
Medicare Allowed$28.64
Medicare Payment$28.64

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $28.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$29$6011,707+0.1%
Florida$29$3628530.0%
Georgia$29$934490.0%
Illinois$29$3021,8440.0%
Kansas$29$301130.0%
New Jersey$29$5141,4920.0%
Texas$29$3199,2910.0%
Virginia$29$581180.0%
Washington$29$731210.0%
Colorado$29$7311600.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

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