Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
Medicare pricing data for 3,950 providers across 50 states
This is one of the most commonly performed procedures in Medicare, with 1.3 million services annually. Even small pricing inefficiencies here affect millions of patients. 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
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r (HCPCS code U0003) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $73.47, but hospitals typically charge $172.90 — a 2.4x 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 $73.47, your out-of-pocket cost would be approximately $14.69. 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 2.4x more than what Medicare allows for this procedure. Medicare actually pays $73.47 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Delaware | $74 | $164 | 3 | 793 | +0.0% |
| District of Columbia | $74 | $117 | 3 | 65 | +0.0% |
| Georgia | $74 | $120 | 43 | 7,909 | +0.0% |
| Kansas | $74 | $136 | 25 | 4,416 | +0.0% |
| Maine | $74 | $109 | 2 | 1,005 | +0.0% |
| Montana | $74 | $142 | 4 | 25 | +0.0% |
| Nevada | $74 | $130 | 7 | 2,949 | +0.0% |
| New Mexico | $74 | $109 | 5 | 440 | +0.0% |
| North Carolina | $74 | $102 | 107 | 88,546 | +0.0% |
| North Dakota | $74 | $223 | 3 | 59 | +0.0% |
| Oklahoma | $74 | $106 | 18 | 1,707 | +0.0% |
| Pennsylvania | $74 | $150 | 20 | 10,882 | +0.0% |
| Rhode Island | $74 | $134 | 5 | 485 | +0.0% |
| South Dakota | $74 | $164 | 19 | 58 | +0.0% |
| Alaska | $74 | $172 | 9 | 76 | +0.0% |
| Illinois | $73 | $172 | 348 | 329,704 | +0.0% |
| Louisiana | $73 | $149 | 22 | 14,110 | +0.0% |
| South Carolina | $73 | $95 | 21 | 5,287 | +0.0% |
| Arizona | $73 | $204 | 17 | 24,958 | +0.0% |
| California | $73 | $184 | 194 | 446,240 | +0.0% |
| Colorado | $73 | $191 | 17 | 6,234 | +0.0% |
| Indiana | $73 | $157 | 14 | 3,712 | +0.0% |
| New York | $73 | $197 | 566 | 39,914 | +0.0% |
| Florida | $73 | $223 | 131 | 34,803 | 0.0% |
| Hawaii | $73 | $137 | 2 | 1,949 | 0.0% |
| Missouri | $73 | $84 | 23 | 4,514 | 0.0% |
| Oregon | $73 | $220 | 63 | 7,001 | 0.0% |
| Massachusetts | $73 | $139 | 448 | 6,522 | -0.0% |
| Ohio | $73 | $119 | 19 | 11,163 | -0.0% |
| Virginia | $73 | $191 | 37 | 12,613 | -0.0% |
| Connecticut | $73 | $221 | 57 | 1,855 | -0.0% |
| Michigan | $73 | $178 | 30 | 5,994 | -0.0% |
| New Jersey | $73 | $191 | 226 | 105,772 | -0.1% |
| Maryland | $73 | $158 | 128 | 11,539 | -0.1% |
| Texas | $73 | $167 | 169 | 56,743 | -0.1% |
| Washington | $73 | $160 | 78 | 9,253 | -0.1% |
| Arkansas | $73 | $148 | 31 | 1,447 | -0.1% |
| Kentucky | $73 | $156 | 49 | 4,508 | -0.1% |
| Mississippi | $73 | $106 | 9 | 3,520 | -0.2% |
| Tennessee | $73 | $141 | 127 | 12,659 | -0.2% |
| Utah | $73 | $184 | 9 | 2,556 | -0.2% |
| New Hampshire | $73 | $109 | 17 | 384 | -0.2% |
| Alabama | $73 | $138 | 30 | 3,264 | -0.3% |
| West Virginia | $73 | $220 | 4 | 155 | -0.6% |
| Minnesota | $73 | $164 | 648 | 4,517 | -0.7% |
| Nebraska | $73 | $110 | 2 | 258 | -0.7% |
| Wisconsin | $73 | $189 | 77 | 7,766 | -0.8% |
| Puerto Rico | $73 | $114 | 27 | 209 | -0.8% |
| Iowa | $73 | $195 | 25 | 497 | -1.0% |
| Vermont | $69 | $275 | 1 | 18 | -5.5% |
⚠️ 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