87529

Detection test by nucleic acid for herpes simplex virus, amplified probe technique

Medicare pricing data for 921 providers across 43 states

🤖AI Overview

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 nucleic acid for herpes simplex virus, amplified probe technique (HCPCS code 87529) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.35, but hospitals typically charge $76.69 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.35, your out-of-pocket cost would be approximately $6.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.35
Average Hospital Charge
$76.69
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$76.69
Medicare Allowed$34.35
Medicare Payment$34.35

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $34.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$34$2013225+0.1%
Indiana$34$7117158+0.1%
Kentucky$34$112347+0.1%
Louisiana$34$7416282+0.1%
Maine$34$111236+0.1%
Maryland$34$7122980+0.1%
Massachusetts$34$13911690+0.1%
Mississippi$34$756197+0.1%
Nebraska$34$61355+0.1%
Nevada$34$111589+0.1%
Pennsylvania$34$441739,363+0.1%
South Carolina$34$47421+0.1%
South Dakota$34$196450+0.1%
Utah$34$1381266+0.1%
Virginia$34$728202+0.1%
West Virginia$34$245235+0.1%
Puerto Rico$34$60314+0.1%
Arkansas$34$571291+0.1%
Colorado$34$10224557+0.1%
Connecticut$34$177456+0.1%
Missouri$34$545617+0.1%
Ohio$34$8716627+0.1%
Oklahoma$34$58147,128+0.1%
Alabama$34$10410137+0.1%
Arizona$34$8559,681+0.1%
California$34$555827,006+0.1%
Texas$34$8114580,366+0.1%
Michigan$34$63182,460-0.0%
North Carolina$34$35992,658-0.1%
Illinois$34$72534,103-0.1%
Kansas$34$138171,296-0.1%
New York$34$138401,750-0.2%
New Jersey$34$139396,976-0.2%
Oregon$34$12130266-0.4%
Tennessee$34$8812672-0.6%
Iowa$34$10816383-0.6%
Washington$34$681011,949-0.6%
Florida$34$71388,659-0.8%
New Mexico$34$1365113-0.8%
Hawaii$34$1032170-0.8%
Wisconsin$34$29027565-0.9%
Minnesota$34$22564455-1.0%
North Dakota$34$158597-1.8%

⚠️ 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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