Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Medicare pricing data for 25,517 providers across 52 states
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 immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) (HCPCS code 87811) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $40.14, but hospitals typically charge $150.64 — a 3.8x 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 $40.14, your out-of-pocket cost would be approximately $8.03. 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 3.8x more than what Medicare allows for this procedure. Medicare actually pays $40.14 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $41 | $278 | 1,259 | 218,550 | +1.0% |
| Wisconsin | $41 | $121 | 105 | 5,820 | +1.0% |
| Washington | $41 | $100 | 299 | 14,018 | +0.9% |
| Puerto Rico | $41 | $52 | 10 | 192 | +0.9% |
| Delaware | $40 | $72 | 76 | 1,695 | +0.8% |
| Illinois | $40 | $108 | 782 | 46,790 | +0.8% |
| Connecticut | $40 | $101 | 457 | 7,819 | +0.5% |
| Utah | $40 | $69 | 166 | 1,858 | +0.5% |
| Florida | $40 | $125 | 1,451 | 31,419 | +0.5% |
| New Jersey | $40 | $111 | 658 | 16,941 | +0.4% |
| Montana | $40 | $82 | 58 | 757 | +0.4% |
| Iowa | $40 | $82 | 176 | 2,594 | +0.4% |
| Nebraska | $40 | $81 | 139 | 2,033 | +0.4% |
| North Carolina | $40 | $131 | 962 | 22,115 | +0.4% |
| District of Columbia | $40 | $71 | 37 | 892 | +0.3% |
| Maryland | $40 | $79 | 446 | 21,782 | +0.3% |
| Pennsylvania | $40 | $81 | 1,254 | 18,898 | +0.3% |
| Massachusetts | $40 | $88 | 513 | 5,782 | +0.3% |
| California | $40 | $129 | 1,551 | 112,546 | +0.3% |
| New Mexico | $40 | $87 | 105 | 872 | +0.2% |
| Virginia | $40 | $75 | 564 | 8,778 | +0.2% |
| Arkansas | $40 | $108 | 459 | 13,758 | +0.2% |
| New Hampshire | $40 | $76 | 129 | 1,444 | +0.1% |
| Rhode Island | $40 | $75 | 42 | 997 | +0.1% |
| South Dakota | $40 | $83 | 13 | 90 | -0.1% |
| North Dakota | $40 | $84 | 13 | 89 | -0.1% |
| Louisiana | $40 | $97 | 832 | 22,879 | -0.1% |
| Idaho | $40 | $67 | 203 | 2,048 | -0.2% |
| Oklahoma | $40 | $101 | 589 | 14,044 | -0.2% |
| Kansas | $40 | $96 | 197 | 3,011 | -0.3% |
| Indiana | $40 | $100 | 655 | 10,938 | -0.3% |
| South Carolina | $40 | $101 | 611 | 17,776 | -0.3% |
| Tennessee | $40 | $95 | 1,653 | 34,124 | -0.3% |
| Arizona | $40 | $108 | 800 | 8,936 | -0.3% |
| Colorado | $40 | $97 | 566 | 5,636 | -0.4% |
| Alaska | $40 | $119 | 37 | 391 | -0.5% |
| Mississippi | $40 | $92 | 390 | 12,676 | -0.7% |
| Georgia | $40 | $95 | 845 | 15,221 | -0.8% |
| Nevada | $40 | $141 | 147 | 1,249 | -0.8% |
| Michigan | $40 | $67 | 693 | 8,706 | -1.0% |
| Vermont | $40 | $67 | 22 | 93 | -1.0% |
| Hawaii | $40 | $133 | 34 | 366 | -1.1% |
| Ohio | $40 | $92 | 746 | 9,029 | -1.3% |
| Missouri | $39 | $87 | 389 | 6,533 | -2.0% |
| Oregon | $39 | $70 | 246 | 2,225 | -2.5% |
| Texas | $39 | $101 | 2,239 | 40,012 | -2.6% |
| Wyoming | $39 | $77 | 46 | 596 | -2.9% |
| Kentucky | $39 | $63 | 383 | 4,809 | -3.2% |
| Alabama | $39 | $81 | 1,123 | 27,749 | -3.6% |
| Minnesota | $38 | $79 | 86 | 586 | -4.3% |
| West Virginia | $38 | $72 | 193 | 4,985 | -5.2% |
| Maine | $34 | $100 | 27 | 230 | -16.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber