36522

Mechanical separation of white blood cells and platelets from blood

Medicare pricing data for 328 providers across 16 states

🤖AI Overview

This procedure has a 32.7x markup — hospitals charge $3,058 but Medicare allows only $93.40. Uninsured patients may face bills 32.7 times higher than what insurance negotiates. 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

Mechanical separation of white blood cells and platelets from blood (HCPCS code 36522) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $93.40, but hospitals typically charge $3,058 — a 32.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $93.40, your out-of-pocket cost would be approximately $18.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$93.40
Average Hospital Charge
$3,058
Markup Ratio
32.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,057.64
Medicare Allowed$93.40
Medicare Payment$72.54

Hospitals charge 32.7x more than what Medicare allows for this procedure. Medicare actually pays $72.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$103$6,65227252+10.5%
Connecticut$102$5,3896255+8.7%
California$101$4,175461,196+7.8%
Minnesota$98$3,36510131+5.1%
New Jersey$98$2,2539499+4.5%
Colorado$97$1,45918199+3.3%
Florida$96$2,43514264+3.1%
Louisiana$96$1,264672+2.3%
Massachusetts$95$67217507+1.7%
Arizona$93$5316105-0.2%
Tennessee$90$6,244640-3.5%
Texas$90$2,35231415-3.7%
Ohio$89$1,17315218-4.6%
South Carolina$88$4,3055105-6.1%
Missouri$83$3,11012602-10.9%
Indiana$78$5,3565287-16.3%

⚠️ 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