86593

Syphilis test

Medicare pricing data for 300 providers across 32 states

🤖AI Overview

This procedure has a 7.3x markup — hospitals charge $31.30 but Medicare allows only $4.30. Uninsured patients may face bills 7.3 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

Syphilis test (HCPCS code 86593) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.30, but hospitals typically charge $31.30 — a 7.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.30, your out-of-pocket cost would be approximately $0.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.30
Average Hospital Charge
$31.30
Markup Ratio
7.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$31.30
Medicare Allowed$4.30
Medicare Payment$4.30

Hospitals charge 7.3x more than what Medicare allows for this procedure. Medicare actually pays $4.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$4$35141,492+0.2%
Hawaii$4$20217+0.2%
Illinois$4$3411342+0.2%
Kansas$4$375245+0.2%
Kentucky$4$8362+0.2%
Louisiana$4$23540+0.2%
Maryland$4$324233+0.2%
Massachusetts$4$2332287+0.2%
New Jersey$4$32211,926+0.2%
New Mexico$4$92167+0.2%
New York$4$329288+0.2%
North Carolina$4$32111,276+0.2%
Ohio$4$3211308+0.2%
Oklahoma$4$38136+0.2%
Oregon$4$26833+0.2%
Tennessee$4$42245+0.2%
Virginia$4$16575+0.2%
Washington$4$338171+0.2%
West Virginia$4$35115+0.2%
Wisconsin$4$37356+0.2%
Arkansas$4$9330+0.2%
California$4$25351,472+0.2%
Colorado$4$30437+0.2%
Georgia$4$37103520.0%
Texas$4$32191,1550.0%
Alabama$4$3224340.0%
Pennsylvania$4$22979-0.5%
Arizona$4$305174-0.9%
Michigan$4$19413-3.3%
Nevada$4$18275-3.3%
Indiana$4$68116-4.7%
Minnesota$4$192345-6.5%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber