87651

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique

Medicare pricing data for 21,106 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 nucleic acid for strep (streptococcus, group a), amplified probe technique (HCPCS code 87651) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.27, but hospitals typically charge $68.45 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.27, your out-of-pocket cost would be approximately $6.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.27
Average Hospital Charge
$68.45
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$68.45
Medicare Allowed$34.27
Medicare Payment$34.27

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $34.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Vermont$34$951939+0.4%
Puerto Rico$34$35113+0.4%
Arizona$34$5418012,865+0.3%
Florida$34$6959431,020+0.3%
California$34$5884949,830+0.3%
Pennsylvania$34$5589734,619+0.2%
Texas$34$571,218165,732+0.2%
Maryland$34$6027414,777+0.2%
Oklahoma$34$5723220,154+0.1%
Delaware$34$5129450+0.1%
Virginia$34$573439,574+0.1%
Massachusetts$34$1096897,946+0.0%
Utah$34$941402,397+0.0%
Colorado$34$818378,088+0.0%
Illinois$34$891,06122,8760.0%
Arkansas$34$5817216,2960.0%
New Jersey$34$7942812,351-0.0%
Connecticut$34$793492,492-0.0%
New Hampshire$34$12374499-0.1%
North Dakota$34$12285386-0.1%
Wyoming$34$9157297-0.1%
Kansas$34$904073,897-0.2%
Missouri$34$704495,980-0.2%
South Dakota$34$821591,105-0.2%
Louisiana$34$754747,629-0.3%
New York$34$10391121,221-0.3%
Ohio$34$759076,278-0.3%
Indiana$34$855745,556-0.5%
Iowa$34$1453963,731-0.5%
Mississippi$34$8654810,594-0.5%
Montana$34$94112568-0.5%
Michigan$34$752241,385-0.6%
Maine$34$11356207-0.6%
South Carolina$34$713622,453-0.6%
North Carolina$34$991,3247,882-0.7%
Oregon$34$793401,426-0.7%
District of Columbia$34$4730214-0.8%
Minnesota$34$1111,4736,587-0.8%
West Virginia$34$9494772-0.9%
Idaho$34$702041,014-0.9%
Nebraska$34$1052201,119-0.9%
Alaska$34$12874381-1.0%
Wisconsin$34$1304953,338-1.1%
Georgia$34$642671,778-1.3%
Tennessee$34$778966,220-1.3%
Hawaii$34$8845471-1.5%
Washington$34$966243,396-1.6%
Kentucky$34$924943,250-1.6%
Rhode Island$34$7041259-2.2%
Nevada$33$96146880-2.4%
Alabama$33$531221,240-3.3%
New Mexico$33$80102888-3.4%

⚠️ 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