87517

Detection test by nucleic acid for hepatitis b virus, quantification

Medicare pricing data for 385 providers across 34 states

🤖AI Overview

This procedure has a 10.6x markup — hospitals charge $445.13 but Medicare allows only $41.91. Uninsured patients may face bills 10.6 times higher than what insurance negotiates. 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 hepatitis b virus, quantification (HCPCS code 87517) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.91, but hospitals typically charge $445.13 — a 10.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.91, your out-of-pocket cost would be approximately $8.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$41.91
Average Hospital Charge
$445.13
Markup Ratio
10.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$445.13
Medicare Allowed$41.91
Medicare Payment$41.91

Hospitals charge 10.6x more than what Medicare allows for this procedure. Medicare actually pays $41.91 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$42$4532713+0.2%
Indiana$42$227328+0.2%
Kansas$42$4644468+0.2%
Kentucky$42$134225+0.2%
Michigan$42$183971+0.2%
Mississippi$42$327353+0.2%
Nevada$42$4434295+0.2%
New Jersey$42$483165,607+0.2%
New Mexico$42$248120+0.2%
Rhode Island$42$117221+0.2%
Utah$42$167361+0.2%
Colorado$42$5166138+0.2%
Massachusetts$42$39380897+0.1%
New York$42$349131,629+0.1%
Texas$42$452152,616+0.1%
Arizona$42$56041,933+0.1%
Maryland$42$4055676+0.1%
California$42$3775614,512+0.1%
Florida$42$533112,3810.0%
Alabama$42$6424489-0.0%
Pennsylvania$42$3759298-0.1%
North Carolina$42$65284,079-0.2%
Oklahoma$42$4537388-0.3%
Washington$42$4869590-0.3%
Oregon$42$2635161-0.3%
Minnesota$42$52440585-0.4%
Tennessee$42$3143249-0.5%
Virginia$42$1366258-0.5%
Ohio$42$48011421-0.5%
Illinois$42$44111514-0.6%
Hawaii$42$1672559-0.7%
Maine$41$246265-1.1%
Wisconsin$41$2328355-1.2%
Iowa$41$197438-1.9%

⚠️ 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