36514

Mechanical separation of plasma from blood

Medicare pricing data for 1,568 providers across 40 states

🤖AI Overview

This procedure has a 12.0x markup — hospitals charge $1,333 but Medicare allows only $110.83. Uninsured patients may face bills 12.0 times higher than what insurance negotiates. Prices vary significantly by location — from $80 in South Carolina to $413 in Nevada. Where you get this procedure matters more than almost any other factor. 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

Mechanical separation of plasma from blood (HCPCS code 36514) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $110.83, but hospitals typically charge $1,333 — a 12.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$22.17

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $110.83, your out-of-pocket cost would be approximately $22.17. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$110.83
Average Hospital Charge
$1,333
Markup Ratio
12.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,333.10
Medicare Allowed$110.83
Medicare Payment$87.10

Hospitals charge 12.0x more than what Medicare allows for this procedure. Medicare actually pays $87.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$413$6,37114827+272.6%
New Jersey$222$1,12934242+100.6%
New York$161$1,305841,432+45.1%
District of Columbia$101$946958-8.5%
Florida$101$671861,105-9.0%
Maryland$97$48118251-12.6%
Connecticut$97$1,65228291-12.7%
California$96$1,8421533,023-13.2%
Massachusetts$96$73736523-13.3%
Illinois$94$68954531-15.5%
Michigan$94$58536585-15.5%
Virginia$93$1,80056571-16.4%
Pennsylvania$91$1,361631,362-17.7%
Oregon$91$33334199-17.8%
Colorado$91$1,04742213-17.8%
Louisiana$90$1,14723333-18.4%
Washington$90$99413107-18.7%
Utah$90$1,79511108-18.7%
Texas$90$7281172,007-18.9%
Minnesota$90$1,29760307-19.0%
New Mexico$89$1,4924135-19.3%
Georgia$89$1,56633458-19.4%
South Dakota$89$206954-19.7%
New Hampshire$89$689668-19.9%
Ohio$89$55654987-20.1%
Arizona$88$43534380-20.2%
Rhode Island$88$1,542254-20.3%
Missouri$88$1,66242451-20.3%
Kentucky$88$1,01622127-20.7%
Alabama$87$39722208-21.2%
North Carolina$87$1,07488527-21.6%
Iowa$87$7859185-21.8%
Mississippi$87$1,3211127-21.9%
Kansas$86$3537265-22.3%
Nebraska$85$1,05215206-23.0%
Arkansas$85$1,37815412-23.1%
Indiana$82$1,20040382-25.6%
Wisconsin$82$1,12638883-25.9%
Tennessee$82$74556408-26.0%
South Carolina$80$46118380-27.9%

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

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