87511

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

Medicare pricing data for 639 providers across 33 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), amplified probe technique (HCPCS code 87511) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.33, but hospitals typically charge $64.70 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.33, your out-of-pocket cost would be approximately $6.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.33
Average Hospital Charge
$64.70
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$64.70
Medicare Allowed$34.33
Medicare Payment$34.33

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $34.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Iowa$34$65113+0.2%
Louisiana$34$8313206+0.2%
Maryland$34$64416+0.2%
Massachusetts$34$12215143+0.2%
Minnesota$34$67216+0.2%
Mississippi$34$1007870+0.2%
Nebraska$34$6514184+0.2%
New Mexico$34$92519+0.2%
Ohio$34$70337+0.2%
Pennsylvania$34$4277,121+0.2%
Rhode Island$34$65112+0.2%
South Carolina$34$41211+0.2%
Virginia$34$7515131+0.2%
Arkansas$34$56582+0.2%
Colorado$34$8026561+0.2%
Michigan$34$54122,030+0.1%
Arizona$34$51326,068+0.1%
Missouri$34$6281,818+0.1%
Oklahoma$34$56215,444+0.1%
Florida$34$532721,165+0.0%
Kansas$34$749523+0.0%
Tennessee$34$97181,6410.0%
Texas$34$577511,343-0.0%
Illinois$34$66521,302-0.1%
New Jersey$34$125698,144-0.1%
New York$34$12383851-0.1%
Maine$34$551116-0.5%
California$34$6645997-1.1%
Washington$34$7718596-1.3%
North Carolina$34$57362-1.4%
Nevada$34$82559-1.5%
Oregon$34$1001448-1.6%
Alabama$31$461088-8.9%

⚠️ 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