87505

Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 3-5 targets

Medicare pricing data for 615 providers across 34 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 digestive tract pathogen, multiple types or subtypes, 3-5 targets (HCPCS code 87505) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $124.77, but hospitals typically charge $280.57 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $124.77, your out-of-pocket cost would be approximately $24.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$124.77
Average Hospital Charge
$280.57
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$280.57
Medicare Allowed$124.77
Medicare Payment$124.77

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $124.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$126$466690+0.8%
Idaho$126$225482+0.8%
Illinois$126$2573181+0.8%
Indiana$126$2383147+0.8%
Kentucky$126$191239+0.8%
Maine$126$232138+0.8%
Minnesota$126$332263+0.8%
Missouri$126$437311+0.8%
Nebraska$126$175129+0.8%
New Mexico$126$3312376+0.8%
New York$126$499440+0.8%
Oklahoma$126$192211+0.8%
South Carolina$126$163354+0.8%
Colorado$126$332460+0.8%
Washington$126$25516187+0.7%
Pennsylvania$126$16241,801+0.7%
Alabama$126$23625195+0.6%
North Carolina$125$194561,556+0.6%
Texas$125$2181439+0.5%
Tennessee$125$32241546+0.5%
Virginia$125$543662+0.5%
Iowa$125$33459269+0.4%
Oregon$125$3812141+0.2%
Louisiana$125$2613117+0.1%
Utah$125$2141831+0.0%
Kansas$125$329782-0.1%
Wisconsin$125$31812382-0.2%
New Jersey$124$1537194-0.5%
Ohio$124$20613167-0.6%
California$124$351222,424-1.0%
Massachusetts$124$470252548-1.0%
Georgia$119$537217-4.3%
Arizona$115$210312-7.6%
Michigan$113$584449-9.1%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber