87563

Detection of mycoplasma genitalium by dna or rna probe

Medicare pricing data for 529 providers across 36 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 of mycoplasma genitalium by dna or rna probe (HCPCS code 87563) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.35, but hospitals typically charge $66.02 — a 1.9x 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 $34.35, 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
$34.35
Average Hospital Charge
$66.02
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$66.02
Medicare Allowed$34.35
Medicare Payment$34.35

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $34.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$34$166449+0.1%
Kentucky$34$73664+0.1%
Louisiana$34$75101,411+0.1%
Maryland$34$79118,528+0.1%
Massachusetts$34$1309167+0.1%
Mississippi$34$464168+0.1%
Nevada$34$953133+0.1%
North Carolina$34$1115924+0.1%
Ohio$34$887172+0.1%
Oregon$34$581329+0.1%
Rhode Island$34$60113+0.1%
Utah$34$71328+0.1%
Virginia$34$538358+0.1%
West Virginia$34$107111+0.1%
Arkansas$34$613208+0.1%
Michigan$34$58152,101+0.1%
Pennsylvania$34$511427,008+0.1%
Arizona$34$52108,784+0.1%
Florida$34$634418,727+0.0%
Missouri$34$5973,918+0.0%
California$34$83414,388+0.0%
Colorado$34$71211,996+0.0%
Texas$34$6111821,230-0.0%
Indiana$34$4210565-0.1%
New Jersey$34$961912,095-0.1%
Oklahoma$34$65178,053-0.1%
Kansas$34$7971,332-0.1%
Tennessee$34$409472-0.1%
Illinois$34$65332,477-0.3%
New York$34$101292,362-0.4%
Washington$34$11413316-0.8%
Wisconsin$34$1117825-0.9%
Puerto Rico$34$45391-1.0%
New Mexico$34$90156-1.4%
Minnesota$34$273580-2.4%
Alabama$33$53849-4.3%

⚠️ 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