87541

Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique

Medicare pricing data for 277 providers across 26 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 by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique (HCPCS code 87541) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.37, but hospitals typically charge $53.20 — a 1.5x 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 $34.37, 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
$34.37
Average Hospital Charge
$53.20
Markup Ratio
1.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$53.20
Medicare Allowed$34.37
Medicare Payment$34.37

Hospitals charge 1.5x more than what Medicare allows for this procedure. Medicare actually pays $34.37 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$34$48172+0.1%
Florida$34$63195,625+0.1%
Illinois$34$4382,221+0.1%
Indiana$34$403465+0.1%
Kansas$34$79217+0.1%
Michigan$34$528104+0.1%
Mississippi$34$487784+0.1%
Nevada$34$824444+0.1%
New Jersey$34$4172,653+0.1%
New Mexico$34$545165+0.1%
North Carolina$34$51334+0.1%
Ohio$34$705382+0.1%
Oregon$34$601749+0.1%
Pennsylvania$34$44919,977+0.1%
Utah$34$1052171+0.1%
Wisconsin$34$10522,919+0.1%
Arizona$34$5031,267+0.1%
Arkansas$34$502283+0.1%
California$34$474435,972+0.1%
Texas$34$597451,200+0.0%
Oklahoma$34$3875,1240.0%
Louisiana$34$696653-0.2%
Virginia$34$584367-0.2%
Missouri$34$5331,547-0.5%
Washington$34$5013117-0.8%
Alabama$31$407337-11.2%

⚠️ 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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