0089U

Gene expression profiling of melanoma in superficial sample collected by adhesive patch

Medicare pricing data for 2 providers across 2 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

Gene expression profiling of melanoma in superficial sample collected by adhesive patch (HCPCS code 0089U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $743.94, but hospitals typically charge $1,300 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$148.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $743.94, your out-of-pocket cost would be approximately $148.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$743.94
Average Hospital Charge
$1,300
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,299.66
Medicare Allowed$743.94
Medicare Payment$743.94

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $743.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$745$1,038113+0.1%
California$744$1,30019,9960.0%

⚠️ 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