87522

Detection test by nucleic acid for hepatitis c virus, quantification

Medicare pricing data for 696 providers across 42 states

🤖AI Overview

This procedure has a 11.6x markup — hospitals charge $485.97 but Medicare allows only $41.94. Uninsured patients may face bills 11.6 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 c virus, quantification (HCPCS code 87522) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.94, but hospitals typically charge $485.97 — a 11.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.39

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.94, your out-of-pocket cost would be approximately $8.39. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$41.94
Average Hospital Charge
$485.97
Markup Ratio
11.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$485.97
Medicare Allowed$41.94
Medicare Payment$41.94

Hospitals charge 11.6x more than what Medicare allows for this procedure. Medicare actually pays $41.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$42$56742,092+0.1%
Idaho$42$197214+0.1%
Iowa$42$218782+0.1%
Massachusetts$42$550862,202+0.1%
Michigan$42$18112315+0.1%
Nevada$42$5245593+0.1%
New Hampshire$42$2581119+0.1%
New Mexico$42$4044183+0.1%
Oregon$42$2167377+0.1%
Pennsylvania$42$5549790+0.1%
Rhode Island$42$1724105+0.1%
South Carolina$42$121644+0.1%
South Dakota$42$168584+0.1%
Utah$42$182775+0.1%
Puerto Rico$42$50842+0.1%
Colorado$42$48010397+0.1%
Connecticut$42$298221+0.1%
Louisiana$42$516261+0.1%
California$42$48110912,010+0.1%
Florida$42$566198,212+0.0%
Kansas$42$56661,556+0.0%
Maryland$42$47081,104+0.0%
New Jersey$42$494189,980+0.0%
Texas$42$499335,380+0.0%
Alabama$42$51851,442+0.0%
New York$42$339141,881+0.0%
Oklahoma$42$44569510.0%
Mississippi$42$30410646-0.0%
North Carolina$42$531118,757-0.0%
Virginia$42$1538578-0.0%
Illinois$42$572151,469-0.1%
Arizona$42$46372,673-0.1%
Ohio$42$417151,788-0.1%
Tennessee$42$23581,053-0.1%
Wisconsin$42$37114427-0.1%
Hawaii$42$2222266-0.2%
Minnesota$42$411106612-0.3%
Washington$42$41654990-0.5%
Kentucky$42$1088159-0.5%
Maine$42$2102117-0.6%
Indiana$41$2836140-1.1%
North Dakota$41$158631-3.1%

⚠️ 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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