87636

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b

Medicare pricing data for 6,746 providers across 52 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 multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b (HCPCS code 87636) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $138.36, but hospitals typically charge $289.01 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.67

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $138.36, your out-of-pocket cost would be approximately $27.67. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$138.36
Average Hospital Charge
$289.01
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$289.01
Medicare Allowed$138.36
Medicare Payment$138.36

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $138.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Vermont$140$405211+1.0%
Delaware$140$156223,234+1.0%
Illinois$140$19724341,692+1.0%
New York$140$29555172,199+0.9%
New Jersey$140$30426121,319+0.9%
Wyoming$140$16319485+0.9%
California$140$26240944,874+0.8%
Wisconsin$139$27843726+0.8%
Rhode Island$139$35319194+0.8%
Nevada$139$4989403+0.6%
Massachusetts$139$3702344,580+0.5%
Minnesota$139$299204827+0.4%
Maine$139$1783378+0.4%
Arkansas$139$1601402,250+0.4%
Hawaii$139$2198295+0.4%
Nebraska$139$29934133+0.3%
Connecticut$139$2051522,406+0.2%
Missouri$139$419991,494+0.2%
West Virginia$139$14821860+0.2%
Montana$139$24143430+0.1%
District of Columbia$138$254497-0.0%
Mississippi$138$2981684,300-0.0%
Pennsylvania$138$284623,139-0.2%
Louisiana$138$2471092,362-0.2%
Indiana$138$272971,023-0.3%
Colorado$138$2732722,236-0.3%
Oregon$138$37812220-0.4%
Kentucky$137$4094829,234-0.7%
North Dakota$137$448847-0.7%
South Carolina$137$2581824,670-0.8%
Michigan$137$2262363,500-0.9%
Texas$137$40242137,559-1.1%
Oklahoma$137$27850820-1.1%
South Dakota$137$17033212-1.1%
Tennessee$137$35448910,855-1.3%
Ohio$137$2111933,584-1.3%
North Carolina$136$2233215,568-1.4%
Idaho$135$25629180-2.5%
New Mexico$135$31639343-2.6%
Iowa$135$25325978-2.7%
Washington$134$3471784,627-3.0%
Alaska$134$38813109-3.1%
Florida$134$3262014,121-3.2%
Georgia$134$365961,627-3.4%
New Hampshire$133$24444284-3.8%
Alabama$132$160991,471-4.3%
Virginia$132$2441091,710-4.7%
Maryland$131$2701042,252-5.0%
Kansas$131$32646572-5.6%
Utah$128$20943665-7.5%
Arizona$126$211602,279-9.0%
Puerto Rico$96$98312-30.6%

⚠️ 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