Immunology · 87340

Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen

What Medicare pays for 87340, what providers bill, and how the price varies across 50 states, drawn from CMS 2023 claims data.

87340 · the short answer

For detection test by immunoassay technique for hepatitis b surface antigen, Medicare pays about $10.09 while providers bill $70.94 on average, a 7.0× markup, a higher-than-typical markup. State-level Medicare rates range 6% from lowest to highest.

Medicare pays
$10.09
Providers bill
$70.94
Markup
7.0×
Markup percentile
75th

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$10.09
What Medicare actually pays
Billed Charge (avg)
$70.94
What providers submit
Markup
7.0x
603% above Medicare rate
278.6K
Total Services
259.2K
Beneficiaries
3.2K
Providers
50
States with Data

Price Range Across States

Lowest State Avg
$9.54
Mississippi
Highest State Avg
$10.12
Alaska

What You Might Pay

Est. Commercial Insurance
$22.60
Range: $15.82 – $31.64
Est. Cash / Self-Pay
$27.08
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Immunology procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

7 Among the most affordable more affordable than 75% of 8,901 procedures

1–2: 466 procedures (5%). Below this entry. 2–3: 681 procedures (8%). Below this entry. 3–4: 845 procedures (9%). Below this entry. 4–5: 1,308 procedures (15%). Below this entry. 5–6: 1,725 procedures (19%). Below this entry. 6–7: 1,217 procedures (14%). Below this entry. 7–8: 801 procedures (9%). This entry sits in this band. 8–9: 541 procedures (6%). Above this entry. 9–10: 351 procedures (4%). Above this entry. 10–11: 246 procedures (3%). Above this entry. 11–12: 151 procedures (2%). Above this entry. 12–13: 175 procedures (2%). Above this entry. 13–14: 140 procedures (2%). Above this entry. 14–15: 40 procedures (0%). Above this entry. 15–16: 39 procedures (0%). Above this entry. 16–17: 26 procedures (0%). Above this entry. 17–18: 25 procedures (0%). Above this entry. 18–19: 21 procedures (0%). Above this entry. 19–20: 12 procedures (0%). Above this entry. 20–21: 16 procedures (0%). Above this entry. 21–22: 13 procedures (0%). Above this entry. 22–23: 8 procedures (0%). Above this entry. 23–24: 9 procedures (0%). Above this entry. 24–25: 4 procedures (0%). Above this entry. 25–26: 3 procedures (0%). Above this entry. 26–27: 3 procedures (0%). Above this entry. 27–28: 4 procedures (0%). Above this entry. 28–29: 3 procedures (0%). Above this entry. 29–30: 2 procedures (0%). Above this entry. 30–31: 26 procedures (0%). Above this entry. this procedure 1 31 × markup, bucketed by value

Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

Prices by State

State Medicare Payment Billed Charge
Alaska $10.12 $90.77
Delaware $10.12 $27.95
Louisiana $10.12 $67.40
Montana $10.12 $52.93
New Hampshire $10.12 $28.85
New Mexico $10.12 $44.83
West Virginia $10.12 $61.24
U.S. Virgin Islands $10.12 $10.40
Georgia $10.12 $86.18
Massachusetts $10.11 $59.57
Kansas $10.11 $85.26
Maryland $10.11 $77.90
Illinois $10.11 $68.76
New Jersey $10.11 $72.96
Texas $10.11 $72.96
Colorado $10.10 $82.68
North Carolina $10.10 $74.73
New York $10.10 $67.85
Nevada $10.10 $86.06
South Dakota $10.10 $53.89
Ohio $10.09 $64.55
Pennsylvania $10.09 $58.90
Michigan $10.09 $29.85
Arizona $10.09 $76.05
Hawaii $10.08 $38.29
Puerto Rico $10.08 $11.46
Virginia $10.08 $43.31
Alabama $10.07 $69.83
California $10.07 $73.79
Missouri $10.07 $26.67
Connecticut $10.07 $48.58
Idaho $10.07 $44.62
Oklahoma $10.06 $50.15
Kentucky $10.06 $29.29
Minnesota $10.06 $68.27
Oregon $10.06 $36.82
Florida $10.05 $74.55
South Carolina $10.04 $58.95
Washington $10.04 $69.71
Iowa $10.03 $43.56
Maine $10.03 $32.14
Tennessee $10.03 $61.99
Utah $10.02 $21.06
Rhode Island $10.02 $40.29
North Dakota $9.99 $74.32
Nebraska $9.98 $23.16
Indiana $9.92 $37.70
Wisconsin $9.81 $64.06
Arkansas $9.64 $26.53
Mississippi $9.54 $44.14

What the Data Says About Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen

Across 50 states with reporting providers, CPT code 87340 (Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen) shows a national average Medicare payment of $10.09 against an average billed charge of $70.94. That gap, a 7.0x markup, or 603% above the Medicare allowed amount, runs well above the median for tracked procedures, a sign the chargemaster rate here is more aspirational than transactional.

Immunology procedures like this one saw 278.6K services billed to Medicare in 2023 by 3.2K distinct providers, serving 259.2K unique beneficiaries. State-level variation is significant: Mississippi reports the lowest average payment at $9.54, while Alaska reports the highest at $10.12. At just 6%, this procedure prices remarkably consistently nationwide, GPCI adjustments barely move the needle for this particular code.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Immunology category (2.24x), the estimated commercial insurance price lands near $22.60, with self-pay cash discounts commonly bringing the figure closer to $27.08. Within Immunology, Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen ranks #206 of 225 tracked procedures by national average Medicare payment.

What to do with this

If you may have detection test by immunoassay technique for hepatitis b surface antigen done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare detection test by immunoassay technique for hepatitis b surface antigen costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen cost?

Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen (CPT 87340) is priced fairly consistently nationwide: Medicare pays $10.09 on average, and the $9.54-$10.12 state range stays relatively tight. Providers typically bill $70.94.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen cost with insurance?

With commercial insurance, detection test by immunoassay technique for hepatitis b surface antigen costs an estimated $22.60 on average (range: $15.82-$31.64), a moderate premium over Medicare's $10.09. Without insurance, the estimated cash price is $27.08.

Which state has the lowest cost for Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen?

Mississippi and Alaska bookend the range for Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen, at $9.54 and $10.12 respectively - a relatively tight $0.58 spread nationwide.

How many providers perform Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen?

A moderate provider base performs Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen: 3.2K providers nationally, totaling 278.6K Medicare-billed services (259.2K beneficiaries) across 50 states in 2023.

What is the billed-to-Medicare markup for Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen?

Providers bill 7.0x what Medicare pays for Detection Test By Immunoassay Technique For Hepatitis B Surface Antigen - a higher-than-typical markup at 603% above the Medicare rate.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.