87653

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique

Medicare pricing data for 1,525 providers across 41 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 strep (streptococcus, group b), amplified probe technique (HCPCS code 87653) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.36, but hospitals typically charge $61.89 — a 1.8x 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 $34.36, 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
$34.36
Average Hospital Charge
$61.89
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$61.89
Medicare Allowed$34.36
Medicare Payment$34.36

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $34.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$34$5419395+0.1%
Idaho$34$631361+0.1%
Indiana$34$39913,342+0.1%
Minnesota$34$599573+0.1%
Nebraska$34$6515293+0.1%
Ohio$34$70112,537+0.1%
Oregon$34$652684+0.1%
Pennsylvania$34$462281,831+0.1%
South Carolina$34$49538+0.1%
Utah$34$10541,894+0.1%
Wisconsin$34$12613110+0.1%
Wyoming$34$355151+0.1%
California$34$539752,849+0.1%
Connecticut$34$64430+0.1%
Louisiana$34$713610,064+0.1%
North Carolina$34$5372,239+0.1%
Virginia$34$693310,845+0.1%
Arizona$34$501213,090+0.1%
Colorado$34$887611,677+0.1%
Florida$34$6011164,647+0.0%
Maryland$34$895922,898+0.0%
Michigan$34$50233,677+0.0%
Washington$34$73311,779+0.0%
Massachusetts$34$90483,7520.0%
Missouri$34$66112,865-0.0%
New Jersey$34$784419,433-0.0%
Texas$34$59361159,815-0.0%
Illinois$34$617624,721-0.1%
Oklahoma$34$543822,904-0.1%
Kansas$34$7581,711-0.1%
Mississippi$34$847116,741-0.1%
Nevada$34$837491-0.1%
New York$34$1105217,181-0.1%
Delaware$34$90232,773-0.1%
Iowa$34$7215263-0.1%
Arkansas$34$694622,038-0.2%
Tennessee$34$76352,263-0.2%
New Mexico$34$7911449-0.8%
Kentucky$34$481189-1.0%
Alabama$34$6717296-1.6%
District of Columbia$32$48321-7.4%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber