Unlisted microbiology procedure
Medicare pricing data for 30 providers across 12 states
Prices vary significantly by location — from $38 in Florida to $287 in California. Where you get this procedure matters more than almost any other factor. 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
Unlisted microbiology procedure (HCPCS code 87999) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $243.50, but hospitals typically charge $744.31 — a 3.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $243.50, your out-of-pocket cost would be approximately $48.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $243.50 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $287 | $896 | 4 | 6,086 | +17.8% |
| Hawaii | $243 | $386 | 1 | 196 | -0.2% |
| West Virginia | $241 | $729 | 1 | 3,652 | -1.1% |
| Kansas | $239 | $815 | 1 | 2,260 | -1.8% |
| North Carolina | $237 | $733 | 4 | 10,662 | -2.9% |
| Georgia | $233 | $793 | 2 | 1,897 | -4.5% |
| Washington | $232 | $743 | 2 | 655 | -4.6% |
| Arizona | $231 | $647 | 1 | 9,287 | -4.9% |
| Alabama | $221 | $831 | 2 | 21 | -9.1% |
| Nevada | $217 | $761 | 1 | 273 | -10.8% |
| Minnesota | $41 | $474 | 2 | 72 | -83.0% |
| Florida | $38 | $564 | 1 | 28 | -84.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber