87088

Bacterial urine culture

Medicare pricing data for 6,867 providers across 50 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 2.2 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

Bacterial urine culture (HCPCS code 87088) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.92, but hospitals typically charge $30.94 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.58

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.92, your out-of-pocket cost would be approximately $1.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.92
Average Hospital Charge
$30.94
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$30.94
Medicare Allowed$7.92
Medicare Payment$7.92

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $7.92 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$8$1611,520+0.1%
Florida$8$31432267,033+0.1%
Georgia$8$345189,446+0.1%
Illinois$8$29124104,984+0.1%
Kansas$8$353467,990+0.1%
Maryland$8$361239,211+0.1%
Massachusetts$8$303693,385+0.1%
Missouri$8$352018,563+0.1%
Montana$8$24643+0.1%
New Hampshire$8$30121+0.1%
Oklahoma$8$302227,986+0.1%
Pennsylvania$8$262753,220+0.1%
Rhode Island$8$172913+0.1%
South Carolina$8$261019,466+0.1%
Wyoming$8$6817382+0.1%
Kentucky$8$18988,2830.0%
Louisiana$8$324613,2310.0%
Michigan$8$29258,1220.0%
New Jersey$8$37622319,8670.0%
New Mexico$8$32108840.0%
New York$8$3359925,8020.0%
North Carolina$8$29130153,1650.0%
Texas$8$30334212,4400.0%
Virginia$8$3613018,8270.0%
Washington$8$2746646,7970.0%
Arizona$8$2321399,5360.0%
Colorado$8$312030,2420.0%
Hawaii$8$2036,922-0.1%
Idaho$8$35181,203-0.1%
Indiana$8$321329,459-0.1%
Ohio$8$2740970,359-0.1%
Tennessee$8$2525114,795-0.1%
Puerto Rico$8$947210,045-0.1%
California$8$32127256,355-0.1%
Iowa$8$2911456-0.3%
Nevada$8$32820,850-0.3%
North Dakota$8$4024948-0.3%
South Dakota$8$4222928-0.3%
Mississippi$8$3429933-0.4%
Oregon$8$20795,668-0.4%
West Virginia$8$243222-0.4%
Connecticut$8$301621,590-0.4%
Utah$8$211955,668-0.5%
Minnesota$8$381,0768,024-0.6%
Nebraska$8$219287-0.6%
Alabama$8$2411866,804-0.6%
Wisconsin$8$6311511,194-0.8%
Maine$8$2353198-0.9%
District of Columbia$8$194244-3.2%
Arkansas$7$3041334-8.7%

⚠️ 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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