0005U

Test for detecting genes associated with prostate cancer in urine

Medicare pricing data for 4 providers across 1 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

Test for detecting genes associated with prostate cancer in urine (HCPCS code 0005U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $744.28, but hospitals typically charge $995.00 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$148.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $744.28, your out-of-pocket cost would be approximately $148.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$744.28
Average Hospital Charge
$995.00
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$995.00
Medicare Allowed$744.28
Medicare Payment$744.28

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $744.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$744$995212,007+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