2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r
Medicare pricing data for 700 providers across 37 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
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r (HCPCS code U0004) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $73.48, but hospitals typically charge $198.82 — a 2.7x 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 $73.48, your out-of-pocket cost would be approximately $14.70. 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 2.7x more than what Medicare allows for this procedure. Medicare actually pays $73.48 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Delaware | $74 | $110 | 4 | 9,312 | +0.0% |
| Florida | $74 | $210 | 29 | 2,610 | +0.0% |
| Illinois | $74 | $188 | 16 | 78,267 | +0.0% |
| Indiana | $74 | $126 | 3 | 189 | +0.0% |
| Kansas | $74 | $125 | 2 | 296 | +0.0% |
| Kentucky | $74 | $113 | 6 | 2,435 | +0.0% |
| Louisiana | $74 | $299 | 8 | 22,292 | +0.0% |
| Maine | $74 | $125 | 1 | 73 | +0.0% |
| Massachusetts | $74 | $75 | 2 | 261 | +0.0% |
| Michigan | $74 | $167 | 8 | 1,729 | +0.0% |
| Mississippi | $74 | $102 | 4 | 1,177 | +0.0% |
| Missouri | $74 | $116 | 4 | 6,845 | +0.0% |
| Nevada | $74 | $274 | 6 | 7,807 | +0.0% |
| New Jersey | $74 | $146 | 29 | 31,691 | +0.0% |
| New Mexico | $74 | $300 | 1 | 125 | +0.0% |
| New York | $74 | $227 | 20 | 24,997 | +0.0% |
| North Carolina | $74 | $339 | 9 | 11,439 | +0.0% |
| Pennsylvania | $74 | $156 | 18 | 15,854 | +0.0% |
| Tennessee | $74 | $224 | 4 | 370 | +0.0% |
| Utah | $74 | $164 | 2 | 1,872 | +0.0% |
| Virginia | $74 | $183 | 6 | 1,620 | +0.0% |
| Wisconsin | $74 | $171 | 2 | 974 | +0.0% |
| Arizona | $74 | $225 | 1 | 752 | +0.0% |
| Arkansas | $74 | $131 | 3 | 380 | +0.0% |
| Colorado | $74 | $219 | 1 | 100 | +0.0% |
| Connecticut | $74 | $128 | 4 | 534 | +0.0% |
| South Carolina | $73 | $173 | 6 | 9,283 | +0.0% |
| Alabama | $73 | $115 | 12 | 11,197 | +0.0% |
| Georgia | $73 | $132 | 10 | 2,725 | 0.0% |
| Maryland | $73 | $188 | 12 | 4,272 | -0.0% |
| Texas | $73 | $230 | 51 | 11,133 | -0.0% |
| California | $73 | $179 | 48 | 38,114 | -0.0% |
| Ohio | $73 | $126 | 28 | 1,277 | -0.1% |
| Oklahoma | $73 | $423 | 11 | 8,991 | -0.1% |
| Puerto Rico | $73 | $92 | 14 | 51 | -0.2% |
| Oregon | $73 | $128 | 11 | 336 | -0.9% |
| Washington | $71 | $175 | 295 | 1,339 | -3.5% |
⚠️ 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