0239U

Gene analysis of 311 or more genes associated with solid organ cancer in cell-free dna, targeted sequence panel

Medicare pricing data for 1 providers across 1 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

Gene analysis of 311 or more genes associated with solid organ cancer in cell-free dna, targeted sequence panel (HCPCS code 0239U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,424, but hospitals typically charge $5,800 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$684.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3,424, your out-of-pocket cost would be approximately $684.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3,424
Average Hospital Charge
$5,800
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,800.00
Medicare Allowed$3,424.32
Medicare Payment$3,424.32

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $3,424 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$3,424$5,80017,1880.0%

⚠️ 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