87507

Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets

Medicare pricing data for 326 providers across 26 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, 12-25 targets (HCPCS code 87507) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $404.66, but hospitals typically charge $910.65 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$80.93

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $404.66, your out-of-pocket cost would be approximately $80.93. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$404.66
Average Hospital Charge
$910.65
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$910.65
Medicare Allowed$404.66
Medicare Payment$404.66

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $404.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$408$1,2376384+0.9%
Indiana$408$1,216311+0.9%
Iowa$408$544317+0.9%
Maryland$408$1,125821+0.9%
Massachusetts$408$500159+0.9%
Mississippi$408$1,5882035+0.9%
Ohio$408$8343699+0.9%
Pennsylvania$408$661228+0.9%
Rhode Island$408$834117+0.9%
South Dakota$408$1,120817+0.9%
Arkansas$408$8455397+0.9%
California$408$726263,735+0.9%
New York$408$1,661341,487+0.9%
Kansas$408$983241+0.7%
New Jersey$408$67015694+0.7%
Oklahoma$407$730338+0.7%
Arizona$406$8142260+0.4%
Tennessee$406$636316+0.4%
Illinois$405$1,09410176-0.0%
Wisconsin$404$1,39326274-0.1%
North Carolina$402$7174539-0.7%
Alabama$399$4874346-1.4%
Minnesota$396$89772596-2.1%
North Dakota$392$1,534319-3.0%
Washington$389$683391-4.0%
Texas$372$60334528-8.1%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber