87510

Detection test for gardnerella vaginalis (bacteria), direct probe technique

Medicare pricing data for 2,200 providers across 46 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 for gardnerella vaginalis (bacteria), direct probe technique (HCPCS code 87510) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.58, but hospitals typically charge $83.79 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.58, your out-of-pocket cost would be approximately $3.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.58
Average Hospital Charge
$83.79
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$83.79
Medicare Allowed$19.58
Medicare Payment$19.58

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $19.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$20$41651+0.4%
Louisiana$20$54856+0.4%
Maine$20$6264161+0.4%
Maryland$20$1157384+0.4%
Michigan$20$446174+0.4%
New Hampshire$20$353209+0.4%
Ohio$20$87171,367+0.4%
Oklahoma$20$643167+0.4%
Rhode Island$20$50225+0.4%
Tennessee$20$705227+0.4%
West Virginia$20$35665+0.4%
Wyoming$20$74420+0.4%
Alaska$20$11941104+0.4%
Connecticut$20$7312696+0.4%
New Jersey$20$108483,979+0.3%
Florida$20$81122,353+0.3%
Hawaii$20$532417+0.3%
Utah$20$5263456+0.3%
California$20$80444,110+0.3%
North Dakota$20$815221+0.2%
Arizona$20$74381,858+0.2%
Virginia$20$8318429+0.1%
Texas$20$93832,517+0.1%
Illinois$20$1121871,4380.0%
Pennsylvania$20$71251,1660.0%
Kansas$20$7264983-0.1%
Massachusetts$20$104521,062-0.1%
North Carolina$20$881601,654-0.1%
Washington$20$114281,092-0.1%
Nebraska$20$5455493-0.1%
Wisconsin$20$12869173-0.2%
Minnesota$20$754081,598-0.3%
New York$20$801613,586-0.3%
Oregon$20$591111,433-0.3%
Mississippi$20$6967849-0.4%
Indiana$20$933623-0.4%
Colorado$19$7124341-0.5%
Iowa$19$68127868-0.5%
South Dakota$19$292499-0.7%
Missouri$19$491975-0.7%
Idaho$19$5523149-0.9%
Alabama$19$1112310-1.0%
South Carolina$19$1231294-1.2%
Nevada$19$8860538-1.5%
Arkansas$19$491884-2.0%
Montana$19$433114-2.3%

⚠️ 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