87070

Bacterial culture, any other source except urine, blood or stool, aerobic

Medicare pricing data for 4,133 providers across 49 states

🤖AI Overview

This procedure has a 8.6x markup — hospitals charge $72.52 but Medicare allows only $8.44. Uninsured patients may face bills 8.6 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

Bacterial culture, any other source except urine, blood or stool, aerobic (HCPCS code 87070) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.44, but hospitals typically charge $72.52 — a 8.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.69

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.44, your out-of-pocket cost would be approximately $1.69. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.44
Average Hospital Charge
$72.52
Markup Ratio
8.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$72.52
Medicare Allowed$8.44
Medicare Payment$8.44

Hospitals charge 8.6x more than what Medicare allows for this procedure. Medicare actually pays $8.44 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$8$22421+0.1%
Illinois$8$879317,009+0.1%
Louisiana$8$58472,599+0.1%
Maryland$8$541415,741+0.1%
Massachusetts$8$8429515,163+0.1%
Missouri$8$90153,426+0.1%
Nevada$8$6674,061+0.1%
New Mexico$8$4891,106+0.1%
New York$8$6535220,843+0.1%
Pennsylvania$8$77187,392+0.1%
Rhode Island$8$594463+0.1%
Vermont$8$461011+0.1%
Wyoming$8$442165+0.1%
California$8$6912467,119+0.1%
Florida$8$8611361,9250.0%
Georgia$8$558324,1740.0%
Kansas$8$843212,2100.0%
New Jersey$8$7642379,3680.0%
North Carolina$8$784445,5840.0%
Texas$8$8119242,7390.0%
Arizona$8$709413,5230.0%
Maine$8$2915679-0.1%
Michigan$8$41501,964-0.1%
Mississippi$8$45331,009-0.1%
Nebraska$8$2612789-0.1%
Ohio$8$632818,620-0.1%
Oklahoma$8$75225,858-0.1%
Tennessee$8$89945,951-0.1%
Puerto Rico$8$11151692-0.1%
Alabama$8$814215,559-0.1%
Hawaii$8$3735,422-0.2%
North Dakota$8$50211,217-0.2%
Oregon$8$37702,725-0.2%
South Dakota$8$52231,193-0.2%
Utah$8$361211,922-0.2%
Virginia$8$39566,051-0.2%
Colorado$8$84225,271-0.2%
Iowa$8$391352,290-0.4%
New Hampshire$8$3461160-0.4%
Washington$8$6931113,364-0.5%
Indiana$8$37591,805-0.6%
Kentucky$8$40741,781-0.6%
Minnesota$8$505113,196-0.7%
Arkansas$8$24521,253-0.7%
Connecticut$8$5115289-0.8%
West Virginia$8$901189-0.9%
Idaho$8$2715283-1.5%
Wisconsin$8$71725,637-1.5%
South Carolina$8$4034260-3.6%

⚠️ 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

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