87652

Detection test by nucleic acid for strep (streptococcus, group a), quantification

Medicare pricing data for 129 providers across 11 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), quantification (HCPCS code 87652) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $40.90, but hospitals typically charge $91.22 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $40.90, your out-of-pocket cost would be approximately $8.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$40.90
Average Hospital Charge
$91.22
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.22
Medicare Allowed$40.90
Medicare Payment$40.90

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $40.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$41$421388+0.0%
Illinois$41$9431,608+0.0%
Michigan$41$111759+0.0%
Mississippi$41$1043484+0.0%
New Jersey$41$153236+0.0%
New Mexico$41$84435+0.0%
Texas$41$813237,774+0.0%
Louisiana$41$1012676-0.0%
Tennessee$41$104151,474-0.0%
Maryland$41$1212410,532-0.0%
Arkansas$41$129311,440-0.3%

⚠️ 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