Detection test by nucleic acid for organism, quantification
Medicare pricing data for 526 providers across 37 states
This procedure has a 6.5x markup — hospitals charge $272.27 but Medicare allows only $41.84. Uninsured patients may face bills 6.5 times higher than what insurance negotiates. 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 organism, quantification (HCPCS code 87799) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.84, but hospitals typically charge $272.27 — a 6.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.84, your out-of-pocket cost would be approximately $8.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $41.84 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $42 | $96 | 5 | 2,220 | +0.3% |
| Massachusetts | $42 | $556 | 7 | 3,728 | +0.3% |
| Michigan | $42 | $274 | 10 | 458 | +0.3% |
| Nevada | $42 | $531 | 3 | 958 | +0.3% |
| Puerto Rico | $42 | $50 | 3 | 25 | +0.3% |
| Pennsylvania | $42 | $91 | 9 | 21,490 | +0.3% |
| Alabama | $42 | $519 | 3 | 2,536 | +0.3% |
| Colorado | $42 | $393 | 7 | 868 | +0.3% |
| Georgia | $42 | $181 | 4 | 6,378 | +0.3% |
| Tennessee | $42 | $140 | 20 | 2,460 | +0.3% |
| Maryland | $42 | $157 | 28 | 25,111 | +0.3% |
| New Jersey | $42 | $353 | 11 | 19,360 | +0.3% |
| New York | $42 | $233 | 8 | 2,684 | +0.3% |
| Illinois | $42 | $419 | 17 | 5,572 | +0.2% |
| Texas | $42 | $208 | 50 | 23,693 | +0.2% |
| California | $42 | $372 | 47 | 26,143 | +0.1% |
| Utah | $42 | $145 | 11 | 1,843 | +0.1% |
| Florida | $42 | $402 | 17 | 9,962 | +0.0% |
| Oklahoma | $42 | $70 | 16 | 11,898 | -0.0% |
| Virginia | $42 | $156 | 5 | 1,657 | -0.0% |
| Kentucky | $42 | $151 | 2 | 162 | -0.2% |
| Mississippi | $42 | $106 | 9 | 1,616 | -0.3% |
| North Carolina | $42 | $524 | 8 | 10,979 | -0.3% |
| Kansas | $42 | $517 | 9 | 3,653 | -0.4% |
| Arizona | $42 | $455 | 8 | 5,927 | -0.4% |
| Arkansas | $42 | $132 | 32 | 6,010 | -0.4% |
| Indiana | $42 | $203 | 38 | 351 | -0.5% |
| Ohio | $42 | $343 | 12 | 2,086 | -0.7% |
| Hawaii | $42 | $355 | 2 | 1,250 | -0.7% |
| Iowa | $41 | $151 | 6 | 561 | -0.9% |
| Minnesota | $41 | $308 | 42 | 5,020 | -0.9% |
| South Dakota | $41 | $271 | 3 | 256 | -1.0% |
| Washington | $41 | $422 | 11 | 1,775 | -1.5% |
| Oregon | $41 | $268 | 6 | 861 | -1.8% |
| New Mexico | $41 | $320 | 13 | 512 | -1.9% |
| Maine | $40 | $216 | 2 | 256 | -4.0% |
| Wisconsin | $40 | $285 | 19 | 2,290 | -4.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber