87556

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

Medicare pricing data for 223 providers across 24 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 tuberculosis (tb bacteria), amplified probe technique (HCPCS code 87556) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $40.78, but hospitals typically charge $67.53 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.16

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $40.78, your out-of-pocket cost would be approximately $8.16. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$40.78
Average Hospital Charge
$67.53
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$67.53
Medicare Allowed$40.78
Medicare Payment$40.78

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $40.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$41$196419+0.2%
Hawaii$41$154240+0.2%
Illinois$41$5963,079+0.2%
Michigan$41$83119+0.2%
North Carolina$41$2412935+0.2%
Ohio$41$866993+0.2%
Oklahoma$41$64565+0.2%
Washington$41$2313106+0.2%
Wyoming$41$5771115+0.2%
Alabama$41$241118+0.2%
Pennsylvania$41$51716,901+0.1%
Virginia$41$5453,508+0.1%
California$41$100211,615+0.1%
Texas$41$545815,558+0.1%
Maryland$41$4521,082+0.1%
Missouri$41$6632,584+0.0%
Florida$41$78224,830+0.0%
New York$41$119124,916-0.1%
Kansas$41$872380-0.3%
Colorado$41$8419397-0.3%
New Jersey$40$5073,866-1.5%
Minnesota$40$428625-2.8%
Mississippi$39$72124-3.7%
Arizona$39$187617-4.6%

⚠️ 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