87913

Genotype analysis of severe acute respiratory syndrome coronavirus 2 (covid-19) by nucleic acid for identification of mutations in targeted regions

Medicare pricing data for 34 providers across 4 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

Genotype analysis of severe acute respiratory syndrome coronavirus 2 (covid-19) by nucleic acid for identification of mutations in targeted regions (HCPCS code 87913) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $252.25, but hospitals typically charge $481.42 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$50.45

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $252.25, your out-of-pocket cost would be approximately $50.45. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$252.25
Average Hospital Charge
$481.42
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$481.42
Medicare Allowed$252.25
Medicare Payment$252.25

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $252.25 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kentucky$253$4001117+0.4%
Texas$252$4541045,815+0.0%
California$252$500241,857+0.0%
Illinois$252$500627,004-0.0%

⚠️ 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