0077U

Detection of immunoglobulin paraprotein (m-protein) in blood or urine

Medicare pricing data for 24 providers across 4 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 of immunoglobulin paraprotein (m-protein) in blood or urine (HCPCS code 0077U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $42.26, but hospitals typically charge $177.33 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.45

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $42.26, your out-of-pocket cost would be approximately $8.45. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$42.26
Average Hospital Charge
$177.33
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$177.33
Medicare Allowed$42.26
Medicare Payment$42.26

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $42.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$43$2771127+0.7%
Arizona$42$1501167+0.4%
Minnesota$42$17856,747+0.1%
Florida$40$1251266-4.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber