87637

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

Medicare pricing data for 4,142 providers across 51 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), influenza virus types a and b, and respiratory syncytial virus (HCPCS code 87637) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $139.61, but hospitals typically charge $342.31 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $139.61, your out-of-pocket cost would be approximately $27.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$139.61
Average Hospital Charge
$342.31
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$342.31
Medicare Allowed$139.61
Medicare Payment$139.61

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $139.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$140$206821+0.1%
Idaho$140$1761081+0.1%
New Hampshire$140$2142597+0.1%
New Mexico$140$25717109+0.1%
North Dakota$140$25614124+0.1%
Vermont$140$33519142+0.1%
Wyoming$140$279721+0.1%
Puerto Rico$140$200114+0.1%
Connecticut$140$30445599+0.1%
Illinois$140$260120215,571+0.1%
Pennsylvania$140$311311,456+0.1%
Texas$140$481282200,182+0.1%
California$140$27566283,726+0.1%
Oklahoma$140$192372,932+0.0%
New Jersey$140$280758,063+0.0%
Arizona$140$2221416,518+0.0%
Wisconsin$140$4861692,574-0.1%
Delaware$139$14711851-0.1%
Colorado$139$31157505-0.1%
Michigan$139$269933,124-0.1%
New York$139$34529615,648-0.2%
Rhode Island$139$3686304-0.2%
Washington$139$29494536-0.2%
Louisiana$139$261542,001-0.2%
Kansas$139$20759690-0.3%
North Carolina$139$2322027,432-0.3%
Tennessee$139$323351,241-0.3%
Maine$139$25850227-0.4%
Oregon$139$27346400-0.4%
West Virginia$139$29161964-0.5%
Virginia$139$265631,280-0.6%
Massachusetts$139$41885900-0.6%
Arkansas$139$298571,014-0.6%
Missouri$139$23956953-0.6%
Indiana$139$3281844,036-0.8%
Montana$139$22624125-0.8%
Florida$139$233793,194-0.8%
Iowa$138$37433292-0.9%
Mississippi$138$20726291-1.0%
Georgia$138$241541,113-1.1%
Ohio$138$3031084,193-1.1%
Nevada$138$3642170-1.3%
Kentucky$138$332104981-1.4%
South Carolina$138$3461627,310-1.4%
Utah$138$1851248-1.4%
Maryland$137$239344,353-1.6%
Minnesota$136$421140333-2.4%
South Dakota$135$253727-3.1%
Nebraska$133$28934167-5.0%
Alabama$131$149107686-6.2%
Alaska$130$30223110-6.6%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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