87512

Detection test for gardnerella vaginalis (bacteria), quantification

Medicare pricing data for 141 providers across 13 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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), quantification (HCPCS code 87512) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $40.83, but hospitals typically charge $134.10 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.17

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $40.83, your out-of-pocket cost would be approximately $8.17. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$40.83
Average Hospital Charge
$134.10
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$134.10
Medicare Allowed$40.83
Medicare Payment$40.83

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $40.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$41$94452+0.2%
Illinois$41$843879+0.2%
Louisiana$41$112222+0.2%
Michigan$41$108839+0.2%
Mississippi$41$1043210+0.2%
Tennessee$41$10519703+0.2%
California$41$96251+0.2%
Colorado$41$1501413+0.2%
New Jersey$41$15424,314+0.0%
Arkansas$41$129311,177-0.0%
Oklahoma$41$1092183-0.2%
Texas$40$14624340-0.9%
Indiana$40$9736275-1.1%

⚠️ 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