87551

Detection test by nucleic acid for mycobacteria species (bacteria), amplified probe technique

Medicare pricing data for 73 providers across 16 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 mycobacteria species (bacteria), amplified probe technique (HCPCS code 87551) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $47.16, but hospitals typically charge $65.70 — a 1.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $47.16, your out-of-pocket cost would be approximately $9.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$47.16
Average Hospital Charge
$65.70
Markup Ratio
1.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$65.70
Medicare Allowed$47.16
Medicare Payment$47.16

Hospitals charge 1.4x more than what Medicare allows for this procedure. Medicare actually pays $47.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$47$906346+0.3%
Georgia$47$96116+0.3%
Maryland$47$50166+0.3%
Minnesota$47$8621,126+0.3%
New Mexico$47$129259+0.3%
Ohio$47$105346+0.3%
Pennsylvania$47$230215+0.3%
Virginia$47$922431+0.3%
Washington$47$343282+0.3%
Arizona$47$503917+0.3%
Oklahoma$47$4831,909+0.2%
Texas$47$81195,965+0.2%
Arkansas$47$57312,765-0.0%
Illinois$47$5421,614-0.1%
California$47$67107,290-0.2%
North Carolina$47$752510-0.6%

⚠️ 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