87389

Detection test by immunoassay technique for hiv-1 antigen and hiv-1 and hiv-2 antibodies

Medicare pricing data for 3,069 providers across 48 states

🤖AI Overview

This procedure has a 5.1x markup — hospitals charge $120.12 but Medicare allows only $23.55. Uninsured patients may face bills 5.1 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

Detection test by immunoassay technique for hiv-1 antigen and hiv-1 and hiv-2 antibodies (HCPCS code 87389) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.55, but hospitals typically charge $120.12 — a 5.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.55, your out-of-pocket cost would be approximately $4.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$23.55
Average Hospital Charge
$120.12
Markup Ratio
5.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$120.12
Medicare Allowed$23.55
Medicare Payment$23.55

Hospitals charge 5.1x more than what Medicare allows for this procedure. Medicare actually pays $23.55 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$24$1031405+0.2%
Idaho$24$65618+0.2%
Montana$24$63328+0.2%
Nebraska$24$4511148+0.2%
North Dakota$24$93944+0.2%
Utah$24$4531188+0.2%
Vermont$24$543097+0.2%
Colorado$24$148111,358+0.2%
Massachusetts$24$1092727,617+0.2%
Florida$24$1245714,804+0.1%
Georgia$24$110264,492+0.1%
Kansas$24$112365,693+0.1%
Oklahoma$24$70102,528+0.1%
Pennsylvania$24$101242,412+0.1%
California$24$1167532,692+0.1%
Maryland$24$107423,466+0.1%
New Jersey$24$12811927,102+0.1%
Kentucky$24$6017539+0.0%
North Carolina$24$14913921,148+0.0%
Illinois$24$1151585,4290.0%
Nevada$24$109172,1170.0%
New York$24$1314905,5370.0%
Arizona$24$139125,1900.0%
Rhode Island$24$645355-0.0%
Texas$24$12022314,918-0.0%
West Virginia$24$1346309-0.0%
Alabama$24$156144,979-0.0%
Ohio$24$131196,752-0.1%
Iowa$24$5850308-0.1%
Connecticut$23$8044337-0.3%
Michigan$23$70252,130-0.3%
Washington$23$84543,778-0.3%
Louisiana$23$12018395-0.4%
Wisconsin$23$12362625-0.5%
Arkansas$23$4566334-0.5%
Virginia$23$74671,165-0.5%
South Carolina$23$10229373-0.6%
Missouri$23$6849145-0.7%
Tennessee$23$941282,286-0.7%
Oregon$23$4748961-0.7%
Indiana$23$7139288-1.1%
South Dakota$23$85770-1.2%
New Mexico$23$72938-1.3%
Mississippi$23$9328913-1.9%
Puerto Rico$23$2426196-1.9%
Minnesota$23$883801,016-2.3%
Maine$23$3631457-2.4%
Alaska$23$1943175-2.7%

⚠️ 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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