87506

Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets

Medicare pricing data for 448 providers across 21 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, 6-11 targets (HCPCS code 87506) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $257.13, but hospitals typically charge $536.38 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$51.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $257.13, your out-of-pocket cost would be approximately $51.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$257.13
Average Hospital Charge
$536.38
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$536.38
Medicare Allowed$257.13
Medicare Payment$257.13

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $257.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$258$515218+0.2%
Oklahoma$258$371295+0.2%
South Carolina$258$394121+0.2%
California$258$56013148+0.2%
Tennessee$258$40513,753+0.2%
Pennsylvania$258$484201,057+0.2%
Louisiana$258$38540235+0.2%
Florida$258$697321,190+0.2%
New Jersey$257$5611319,672+0.1%
Arkansas$257$542112,470+0.1%
Maryland$257$531372,302+0.0%
Illinois$257$6727327-0.2%
Minnesota$257$532171428-0.2%
Arizona$256$2981604-0.3%
Texas$256$49031901-0.4%
Wisconsin$255$79324104-0.7%
New York$252$4435110-2.1%
Colorado$247$6417233-3.8%
Mississippi$242$5796121-5.9%
Virginia$239$1,765421-7.2%
Ohio$220$285315-14.5%

⚠️ 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