81007

Urinalysis for bacteria

Medicare pricing data for 488 providers across 30 states

🤖AI Overview

Prices vary significantly by location — from $10 in Indiana to $29 in Maine. Where you get this procedure matters more than almost any other factor. 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

Urinalysis for bacteria (HCPCS code 81007) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $29.22, but hospitals typically charge $47.93 — a 1.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $29.22, your out-of-pocket cost would be approximately $5.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$29.22
Average Hospital Charge
$47.93
Markup Ratio
1.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$47.93
Medicare Allowed$29.22
Medicare Payment$29.22

Hospitals charge 1.6x more than what Medicare allows for this procedure. Medicare actually pays $29.22 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maine$29$405780+0.5%
Michigan$29$39997+0.5%
New Mexico$29$44234+0.5%
Oregon$29$60441+0.5%
South Carolina$29$553102+0.5%
Arizona$29$453362,561+0.5%
Colorado$29$531041+0.5%
Louisiana$29$6059,191+0.5%
Missouri$29$4694,910+0.5%
Illinois$29$6051,933+0.5%
Kansas$29$4521,764+0.4%
Kentucky$29$79419+0.4%
North Carolina$29$3562,853+0.3%
Ohio$29$4823505+0.2%
California$29$431206,608+0.2%
Florida$29$43467,413+0.1%
Massachusetts$29$406211-0.1%
Georgia$29$95453,122-0.5%
Oklahoma$29$44664-0.8%
Arkansas$29$1044898-1.2%
Tennessee$28$899345-2.8%
Nevada$28$38421-3.0%
New Jersey$28$4714344-3.5%
Alabama$28$4584,896-3.6%
Texas$27$4748390-8.2%
Mississippi$24$31261,037-17.9%
Pennsylvania$23$38625-20.8%
New York$23$341029-21.0%
Washington$22$22152-26.1%
Indiana$10$17427-64.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber